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 previouscouncil proposed eliminating commercial support of CME, setting off a firestorm of protest. The recommendation was tabled and the report was referred back to CEJA to address concerns brought forth by the Reference Committee.
This time, CEJA, which has all new members, found that relationships with industry can benefit the medical profession and patients. “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 reports says.
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 those who have “modest financial interests” in the educational subject to participate 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” who has direct, substantial, and unavoidable financial interest, if certain steps are taken.
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.