The Bander Center for Medical Business Ethics at Saint Louis University regularly
compiles links to case studies useful for class discussion, legal resources, codes,
guidelines and reports related to medical business ethics.
Patient Physician Sunshine Act Provision (Requirements on financial relationships between manufacturers and distributors of
covered drugs, devices, biologicals, or medical supplies under Medicare, Medicaid,
or CHIP and physicians and other health care entities and between physicians and other
health care entities, including disclosure). This component of the bill requires that
starting in 2012, medical device and pharmaceutical companies will record physician
payments over $10 and that all payments be publicly disclosed.
(All cases gathered from the AMA Journal of Ethicswebsite)
Unnecessary Antibiotics- A physician in a new group pediatrics practice notices colleagues violating a good
clinical protocol for the sake of building a solid patient, and financial, base for
Hidden Costs of Free Samples- A physician is highly skeptical of the overall educational quality of pharmaceutical
representatives, but appreciates the benefits of free medical samples they provide.
The Gift-Giving Influence - A medical school administration member is concerned that his students are unwilling
to accept that their behavior can be influenced by pharmaceutical industry gift-giving.
Clinician and Researcher - A physician sees the potential benefits of enrolling some of his patients into
a clinical trial, and wonders what the ideal conditions of a clinician-turned-researcher
contract would be.
"Can We Just Drop the Copay?" - A patient asks his physician if he could forgive his copay so he can continue to
visit this office, mentioning that 80% of the bill for services will still be paid
The HMO Physician's Duty to Cut Costs- A physician has a duty to providing the best treatment for his patient, but does
a similar duty apply to providing treatment at the most reasonable cost? (Link to
JSTOR Article available with SLU access)
Selected cases in medical business ethics are listed below. For a list of all cases
and associated PDFs, go to theirwebsite.
Conflicting Allegiance- As a consultant for two different companies in addition to being a University employee,
questions are raised about gifts, proper compensation and conflicts of commitment.
Invitation to Dinner - When you are given an offer to attend a pharmaceutical company sponsored dinner,
you weigh the choice between attending and not attending.
Patient Recruitment- Your supervisor is in need of patients for an important clinical trial, and pushes
you to recruit more patients from the clinic, however you have some doubts about your
supervisor's involvement with the study sponsor.
The Clinical Specialist - An company-provided clinical specialist is often present in the operating room
helping with implementation of a new device, however you wonder if her influence over
the medical center's purchase decisions is appropriate.
More cases on topics in medical business ethics are currently being developed. For
comments and suggestions, please contact us at 314-977-1070.