StATS: Ethics and the fiduciary obligation (created 2006-06-19)

One of the regular contributors to the IRBForum noted the publication of the following article:

which is too recently published for me to find a good PubMed record. Another contributor pointed out a competing viewpoint:

These articles caught my eye because a lot of discussion about ethical practice refers to the fiduciary duty of a physician for his/her patients. For example, the organization, No Free Lunch, has the following on its FAQ list:

Q. My friends in the business world are wined and dined all the time. Why should doctors be held to a different (higher) standard than business people? A. Because the doctor-patient relationship, unlike many (but not all) business relationships--but like that between a lawyer-client or congressperson-citizen, is a fiduciary relationship. A fiduciary is someone with specialized skills or knowledge; holds the trust and confidence of others; is accountable and obligated both ethically and legally; who is held to a higher standard of conduct, and who therefore avoids conflicts of interest. All of these characteristics pertain to physicians. Though some may see medicine as “just a business,” clearly—at the present time at least—patients, and society do not see it this way: Patients rightly expect their physician to act in their (the patient’s) best interest. Patients do not enter the examining room caveat emptor. Patients should be confident that the drug being is prescribed is the best, the most cost-effective, not the best promoted.

Another interesting article is

A good technical definition of fiduciary duty/obligation is at

I want to write more about this when I get the chance.

This page was written by Steve Simon while working at Children's Mercy Hospital. Although I do not hold the copyright for this material, I am reproducing it here as a service, as it is no longer available on the Children's Mercy Hospital website. Need more information? I have a page with general help resources. You can also browse for pages similar to this one at Category: Ethics in research.