의료인-제약산업 관계의 이해상충과 윤리적 원칙

This article examines the four principles of biomedical ethics introduced by Beauchamp and Childress for possible use in deliberating ethical issues that arise in the context of physician-pharmaceutical industry interactions (PPII). PPII is regarded as a threat to the ideal physician-patient relationship because it blurs the scientific, objective, and altruistic ideals of professional medical practice. Several guidelines have been proposed to redress the undesirable effects of PPII, but few have provided any ethical justification or mechanism to resolve possible internal conflicts. The principle-based approach is a good starting point because it focuses on practical solutions for decision-making as well as on theoretical justifications. This article shows how the four ethical principles can be specified and applied in three hypothetical cases of PPII, and how two practical rules, the rule of transparency and avoidance, can be assimilated.