DOCTORS AND DRUG COMPANIES
Providence Journal: The Enron scandal has shown what can happen when conflicts of interest go unchecked in the business world. But such conflicts pervade the world of medicine as well. According to a study just published in The Journal of the American Medical Association, an overwhelming majority of doctors who write treatment guidelines for diseases have ties to the pharmaceutical industry. And very often, those companies' drugs find their way into the guidelines as recommended treatment.
To those in the medical profession, none of this is news. The potential for financial conflict is widely recognized, and the source of much discussion.
Rare disclosure: One of the troubling aspects of the new study is its finding that ties between doctors and drug makers are rarely disclosed. That means that the public -- not to mention peer physicians -- are generally left in the dark when it comes to trying to fully appraise recommended treatments.
Drug companies often pay doctors for research, speaking and consulting. And many doctors frequently take junkets to fancy resorts, all bought and paid for the drug companies. Some of these junkets last a weekend, many much longer. A lot of greens fees are being paid for by drug makers. If this involved politicians, this would be called bribery.
The cozy financial relationship between physicians and the drug makers is not easily abolished. But disclosure would do much to keep things above board, and to help guarantee the integrity of scientific research.
Stricter rules: According to a recent New York Times report, several prominent doctors and researchers have signed a letter urging scientific journals to adopt stricter disclosure rules. The Pharmaceutical Research and Manufacturers Association, which represents the industry, has no problem with the idea. Scientific publications can only gain by putting it to use.
It would also be nice if physicians would tell patients what the drug companies whose products the physicians are enthusiastically recommending had done for the doctors lately, but we dream on.
WHAT MAKES A PARENT?
Chicago Tribune: For more than seven decades, the American Academy of Pediatrics has led clarion calls for better childcare -- from breastfeeding to childhood vaccinations to screening newborns' hearing to placing infants on their backs while asleep. It has been an advocate for measures that keep babies healthy, ease their suffering and save lives.
Now, the organization of 55,000 children's doctors is advocating something that would seem much more controversial. The AAP is urging its members to "advocate for initiatives that establish permanency through co-parent or second-parent adoption for children of same-sex partners."
Yes, gay adoption. It is a bold position, one that almost immediately drew fire. And one that is correct.
Ambivalence: State laws across the country are a patchwork of ambivalence when it comes to adoption by gay men and women. Most state statutes are silent on the issue, according to the National Adoption Information Clearinghouse.
Only two states, Florida and Mississippi, specifically prohibit adoption by homosexuals. Utah blocks adoption by individuals living together but not legally married. Connecticut allows sexual orientation of the prospective adoptive parent to be considered in placing a child. State legislatures in Alabama and New Hampshire have issued resolutions prohibiting or discouraging adoption by homosexual couples or gay individuals.
Research, although limited, indicates "that there is no systematic difference between gay and nongay parents in emotional health, parenting skills, and attitudes toward parenting," according to the AAP technical report on the issue. "No data have pointed to any risk to children as a result of growing up in a family with one or more gay parents."
The academy estimates that 1 million to 9 million children in the United States have at least one gay parent.
But this issue isn't really all that much about the acceptance of gay parenting. The issue here is about doing what's best for a child, sometimes in situations that are not to everyone's liking.
De facto parents: Partners of gay parents in many cases already amount to de facto parents. Allowing a gay man or woman to adopt his or her partner's child would establish required child support if the parents separate, the AAP notes, and ensure the child receives health benefits from either or both parents if needed. It would create financial security by making the child eligible for Social Security survivor benefits and other entitlements. It would guarantee that the child has a legal parent, a protector, if the biological parent becomes ill or dies. Those are very real vulnerabilities for children.
In other cases, it is a matter of providing a parent for a child who, otherwise, would be left to the uncertainty and impermanence of living in foster care or an orphanage.
The ideal is a stable family unit with a mother and father who can provide solid, male and female role models for a child. Some may argue that the AAP's position further chips away at the model arrangement of a family. Of course, no law is going to deprive a child of such a family; and many, many children don't live in such an arrangement now. The AAP has made a statement not about politics, but about children's health and well-being. The states would be wise to follow doctors' orders.