The American Medical Association’s Council on Ethical and Judicial Affairs won’t recommend a ban on commercial support, according to its much-anticipated follow-up report, “Financial Relationships With Industry in Continuing Medical Education,” released in early May. The recommendation comes one year after the previous CEJA council proposed eliminating commercial support of CME, setting off a firestorm of protest. The recommendation was ultimately tabled and the report was referred back to CEJA to address concerns brought forth by the Reference Committee.

Consequently, CEJA went back to the drawing board with a council of new members and addressed the issue again. This time, their findings validate the role of commercial support. “Relationships with industry—i.e. pharmaceutical, biotechnology, and medical device companies—can offer enormous benefit to the profession and the patients it serves,” says the report. “However, commercial funding for professional education can pose significant ethical challenges to medicine’s ability to focus primarily on the needs of patients and ensure quality education for physicians.”

The report offers a framework, with three different categories, for obtaining commercial support. It says that it is “ethically preferable,” that CME providers accept funding only from sources that have no direct financial interest in a physician’s clinical recommendations. Also, those involved in CME (either teaching, programming, or developing content) must not have been compensated within the last 12 months by a commercial entity that has a financial interest in the subject matter.

Further, CEJA says it is “ethically permissible” that CME providers accept funding from industry if: 1. the activity is planned by the provider independently and prior to the solicitation of funds, 2. the use of funding is not restricted, 3. the source of funding is disclosed, and 4. the CME provider is not overly reliant on funding from industry sources.

Providers may permit involvement of individuals who have “modest financial interests” in the educational subject if the interests are disclosed and steps are taken to mitigate the potential influence of those interests. “In rare circumstances,” the report adds, providers may permit the involvement of a “uniquely qualified expert” (an inventor of a new device, perhaps) who has direct, substantial, and unavoidable financial interest, if he or she is proven to be the expert in the field; his or her financial interest is disclosed; there is a demonstrated, compelling need for the activity; steps are taken to mitigate the potential influence of financial interest; and an effort is made to develop a pool of qualified, independent experts as quickly as possible.

Anything that falls outside of these guidelines with respect to commercial support would be “ethically prohibited.”

The recommendations will be voted on by the Reference Committee at AMA’s House of Delegates meeting, June 13-17 in Chicago.