Contact with Pharmaceutical Representatives: Where Does Prudence Lead?

摘要

How do prudent people behave when the data available on the consequences of their actions are limited, but a de-cision as to how to behave must be made? With regard to the controversy over physicians' contacts with pharmaceu-tical representatives (referred to as "drug reps" by most clinicians, a usage that I follow here), Huddle (2010) cri-tiques the approach of the Association of American Medical Colleges (AAMC), which has urged academic medical cen-ters to shun such interactions. Huddle argues instead that contacts should not be precluded, but that efforts could be made to mitigate whatever negative effects might ensue. I suggest here that a broader view of the situation—taking four contextual elements into account—leads to a very dif-ferent conclusion about a situation that Huddle correctly characterizes as requiring a "prudential" response.