Ethics & Research in Orthopedics
BY JOHN CHOPACK, NOVEMBER 30, 2005
In the November issue of the British Journal of Bone and Joint Surgery there were two very interesting editorials: "Ethics in Orthopaedic Surgery" by the Presidents' Council of the Combined Orthopaedic Associations and "Which Research is to be Believed" by A.J. Carr. Both of these articles demonstrate the ethical dilemmas facing orthopedic surgeons.
Today, a significant amount of orthopedic research and clinical trials are being funded by large orthopedic manufacturers. This places tremendous pressure on the orthopedic surgeon to generate beneficial results. This conflict of interest is so great that many orthopedic surgeons completely dismiss research funded by an orthopedic manufacturer. However, there is a valid argument that without the funding of these large orthopedic manufacturers there would be a lack of research of novel surgical ideas reducing the amount of innovation within the industry.
The other dilemma facing orthopedic surgeons involves payment for services rendered to the manufacturer. These services typically include consulting on new product design and lecturing. This results in another perceived conflict of interest for the surgeon. The perception is that the surgeon is being paid to use and recommend certain products.
In our opinion, the problem is two fold. A small number of orthopedic surgeons abused the system and took advantage of the situation for their own benefit. Secondly, most people believe that healthcare is an industry that should not allow any person or group to generate a significant profit. To resolve these dilemmas mutual trust and respect needs to be established between the surgeon, manufacturer, and, most importantly, the patient.
