Monday, October 21, 2013

Australasian college of physicians sacks its ethics committee

The Royal Australasian College of Physicians has sacked its own ethics committee just days after the committee produced strict new guidelines on doctors’ ties to industry.

The college has also provoked an outcry by refusing to release its guidelines for public consultation, opting for an internal process instead.

The draft Guidelines for Ethical Relationships Between Health Professionals and Industry had strengthened the already tough, pro-transparency stance of previous editions. Among its recommendations it labelled doctors’ use of drug samples and starter packs as “inappropriate,” it said, given that these were “primarily a marketing exercise.”

The draft guidance also explicitly called on the college to establish processes for publicly declaring its relations with the drug industry and the competing interests of members and office holders—something the college does not currently do.

Three years in the making, the 105 page document briefly appeared on the college’s website in early September before being quickly taken down.

Paul Komesaroff, who chaired the guideline working party and also the now defunct ethics expert advisory group, warned that valid public consultation was “critical” to ensuring the legitimacy and integrity of the final document.

In an open letter to the college’s president, Leslie Bolitho, which was also signed by 12 working party members, Komesaroff said that the draft reflected “the large volume of data now available concerning the nature and impact of relationships between health professionals and components of industry.” Previous editions of the guidance had been influential and “widely quoted around the world,” he said.

Disbanding the ethics committee could “cause serious damage to the College and its national and international standing,” Komesaroff wrote in a second letter, made public by the online newspaper the Global Mail.1

“As far as can be determined, every college in Australia has an ethics process. The abolition of the group representing ethics in the RACP [Royal Australasian College of Physicians] would make it unique,” he wrote. Komesaroff has declined to comment further.

The college did not meet the BMJ’s request for an interview with Bolitho.

In a statement a spokesman said that the college had more than 200 committees and that it was cutting these back to streamline the organisation’s outdated and “overly bureaucratic structure,” after feedback from members.

The spokesman said, “None of this is linked to the release of the draft guidelines for ethical relationships between health professionals and industry.” He added that the draft had been circulated to almost 100 parties for feedback, consistent with standard college practice.

Peter Brooks, a Melbourne rheumatologist and former honorary secretary of the college, said that it was “unfortunate” that the guidelines would not be open to the same public scrutiny as previous editions.

“We’re not being quite as open as we have been perhaps in the past,” he said.

Brooks said that the decision to disband the ethics committee was “fascinating.” He said, “How can an organisation like the college not have an ethics committee? The [implications] are pretty serious in terms of how one does one’s business.”


Cite this as: BMJ 2013;347:f6242

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