Medical conscience

There are certain personal attributes over and above a medical degree and clinical experience that make for a successful pharmaceutical physician. To be valued, the pharmaceutical physician must be able to provide insight into the clinical benefit, and hence the commercial potential, of a compound at any stage in its development. He or she must also have the planning skills to realise that potential, and an ability to communicate at all levels, both inside and outside the company. If the medical department is to act as the compan)r s medical conscience (see Section 10.2),... 

The pharmaceutical physician provides a medical direction to marketing strategy and ensures that product literature and promotional material are legal and factually accurate. This is an important contribution to the medical department s role as medical conscience, as discussed in Section 10.2. Medical input remains necessary to the servicing and support of marketed products throughout their life cycle. 

The problems of educating the public in such matters are many and diverse. It will require not only the support of medical people but that of all individuals who have a social conscience. The interest and sincere efforts of all scientific workers are needed to simplify and hasten this much needed program of public education. 

This activity often described as The Medical and Social Conscience of a company largely resides in the Medical Affairs department. In most large -and medium-sized pharmaceutical companies this responsibility lies with Medical Affairs. The review of all materials, whether detail pieces provided in person to physicians in practice, slide sets for speakers on behalf of the company, general promotional material that is disseminated via print, radio, TV or web must be reviewed and approved by internal committees comprised of Medical Affairs staff, regulatory and legal personnel. In addition to the company review, this material must be sent to FDA at least by the first day of use. Review by FDA s DDMAC should be sought for TV advertisements. 

It was quite clear that the scale of production in the William Dunn School could barely provide enough material for further clinical trials hence, Florey tried to elicit the help of drug companies. ICI, Burroughs Wellcome, Boots and a small London company, Kemball-Bishop, all showed interest but due to the exigencies of war-tom Britain, none had sufficient funds for speculative research. They were probably also worried that a chemical synthesis of penicillin would be devised once its structure had been elucidated thus, money spent on culture technology would be wasted. They were also probably worried about the patent situation. Florey had mentioned this issue to the Medical Research Council, which had provided a modest amount of research money. Apparently, the senior MRC officials were vehemently opposed to patenting on the grounds that it was unethical for medical researchers to benefit from their discoveries. The American pharmaceutical companies suffered no such qualms of conscience, and in due course the British companies had to pay royalties to their US counterparts before they could produce penicillins. 

A hundred years ago, physicians were therapeutic nihilists. They were right there was little chance that a patient would benefit from a professional encounter with a physician. Today, physicians are therapeutic Utopians. They are wrong although patients often benefit from their professional encounters with a physician, sooner or later everyone dies.5 The effort to eradicate disease is a quixotic quest. Not everyone thinks so. Why, asks Emil Freireich, at the University ofTexas Medical Center, should anyone in good conscience. .. imagine that death is apart of life ... If we can understand disease and manipulate it, then I think one of the options that people must consider for themselves is the possibility of life forever. ... 

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