For decades, medical professionals have been betraying the public's trust by accepting various benefits from the pharmaceutical industry. Drug company representatives and doctors alike have promulgated creative rationalizations to portray this behavior positively, as if it really serves the interest of the public. In Hooked: Ethics, the Medical Profession, and the Pharmaceutical Industry, Howard Brody claims that we can neither understand the problem, nor propose helpful solutions until we fully recognize the many levels of activity that connect these two industries. Then, for real improvement to occur, the doctors themselves need to not only change their behavior, but also change how they view the actions of their peers and colleagues. We can pass laws and enact regulations, so that those physicians that do choose to focus on ethics won't be in an environment where they feel as if they are swimming against too strong a current to make meaningful change, but ultimately a profession has to take responsibility for its own integrity.
Howard Brody is professor and director for the Institute for the Medical Humanities, University of Texas Medical Branch at Galveston. Prior to this appointment, Dr. Brody was University Distinguished Professor of family practice, and philosophy at Michigan State University, where he also sat on the faculty of the Center for Ethics and Humanities in the Life Sciences; he served as director of the Center from 1985-2000. Dr. Brody completed his residency in family practice at the University of Virginia Medical Center. He received his MD from the College of Human Medicine, Michigan State University, in 1976, and his PhD in Philosophy, also from Michigan State University, in 1977. He currently sits on the board of the American Society for Bioethics and the Humanities, and specializes in ethics and the doctor-patient relationship. He has authored five books, among them Stories of Sickness (2002) and The Placebo Response: How You Can Release the Body's Inner Pharmacy for Better Health (2000). For up-to-date news about the issues covered in Hooked, visit Dr. Brody's new blog.
Chapter 1 Introduction: The Tipping Point Part 2 I. Overview Chapter 3 1. The Good, the Bad, and the Ugly: A Story of Two Medications Chapter 4 2. An Ethical Framework Part 5 II. Specific Issues and Problems Chapter 6 3. The Pharmaceutical Industry and the Free Market Chapter 7 4. Patents, Generic Drugs, and Academic Science Chapter 8 5. Research and Profits Chapter 9 6. Suppression of Research Data Chapter 10 7. The Quality of Pharmaceutical Research Chapter 11 8. The Drug Rep: Historical Background Chapter 12 9. The Drug Rep Today Chapter 13 10. The Influence of Drug Reps: What the Data Show Chapter 14 11. Continuing Medical Education Chapter 15 12. Professional Organizations and Journal Advertising Chapter 16 13. The Industry and the Consumer Chapter 17 14. The FDA: From Patent Medicine to AIDS Drugs Chapter 18 15. The FDA and the Industry, 1990-2004 Part 19 III. Toward Solutions Chapter 20 16. Solutions: The Management and Divestment Strategies Chapter 21 17. Solutions Requiring Enhanced Professionalism in Medicine Chapter 22 18. Solutions Requiring Regulatory Reform Chapter 23 Epilogue: Industry Woes and Professional Opportunities