Support the movement to strengthen Harvard Medical School's conflict of interest policies to promote evidence-based medicine

October 6, 2008

Dear Dean Flier and senior members of the administration of Harvard Medical School,

The use of pharmaceutical drugs and medical devices is vital to the practice of medicine. The need for safe, affordable, and efficacious medicines and devices is clear and, therefore, the pharmaceutical and device industries play a crucial role in medicine. However, for-profit companies in these industries have a primary responsibility to deliver profits to their shareholders, investors, or owners. The conflict between these financial interests and the ideals of medicineвaltruism, service, and protection of patientsвrequires close evaluation by the medical profession and its institutions of learning. Such conflicts of interest threaten the ethical conduct embodied by the Hippocratic oath and deserved by patients.

The current policies of Harvard Medical School do not sufficiently protect medical students, physicians, and patients from the persuasive and profit-oriented influence of the pharmaceutical and device industries and do not prioritize evidence-based medicine. We, the undersigned students of Harvard Medical School, call on you as leaders to take a strong stand for evidence-based, conflict-free medicine through the following actions:

- Create a single comprehensive conflict of interest policy governing the relationship between our academic medical center and the pharmaceutical and device industries consistent with the recommendations of the Association of American Medical Colleges (AAMC) (1) and Institute on Medicine as a Profession committee report (2) that qualifies as an вAв on the AMSA Scorecard (3) (issues addressed include: gifts to physicians and trainees including travel; pharmaceutical samples and drug formularies; site access by industry representatives; industry sponsored programs such as speakersв bureaus and ghostwriting; and funding for continuing medical education)

- Form a committee of stakeholders including two medical students that will draft the policy specific to Harvard Medical School before the end of the academic year

- Establish independent third-party evaluation of faculty and lecturer disclosures

- Strengthen the requirement of lecturer disclosure to mandate that all lecturers, preceptors, and presenters state both conflicts of interest or the lack thereof

We hold this medical school in high regard. Indeed, we have chosen this institution based on its reputation of excellence in education, research, and clinical care. It is out of our sincere commitment to Harvard Medical School that we ask you as the leaders of this institution to take a stand against conflicts of interest and inappropriate industry influence. HMS students have been advocating for this issue for over six years. We hope this letter demonstrates that the current medical students are committed to receiving an evidence-based, conflict-free medical education during our development as clinicians and researchers that satisfies our own moral judgments and is in the interest of our future patients.


Sources:
(1) Vagelos R, et al. Industry Funding of Medical Education: Report of the AAMC Task Force. June 2008.
(2) Brennan TA, Rothman DJ, Blank L, et al. Health industry practices that create conflicts of interest: A policy proposal for academic medical centers. JAMA. 2006;295:429-433.
(3) AMSA Scorecard, for explanation of criteria and evaluation see www.amsascorecard.org