Medical Education and Financial Conflict of Interest Relationships with the Pharmaceutical Industry in Canada: An Analysis of Four Areas of Medical Education

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dc.contributor.advisorLexchin, Joel. R.
dc.creatorShnier, Adrienne Rebecca
dc.date.accessioned2016-11-25T14:10:11Z
dc.date.available2016-11-25T14:10:11Z
dc.date.copyright2016-07-20
dc.date.issued2016-11-25
dc.date.updated2016-11-25T14:10:10Z
dc.degree.disciplineHealth
dc.degree.levelDoctoral
dc.degree.namePhD - Doctor of Philosophy
dc.description.abstractFinancial conflict of interest (FCOI) relationships in medicine have been found to expose medical education in medical schools, medical journals, and continuing medical education (CME) hosted by professional medical associations (PMAs) to vulnerability to corporate bias. Institutional policy analysis concerning FCOI relationships and industry involvement in medical education in Canada is limited. Therefore, informed by neoliberal corporate bias theory and Mertonian norms of science, this dissertation contributes analyses of conflict of interest policies, disclosures, and opportunities for drug company involvement in the production and dissemination of medical knowledge. In a publication-based dissertation format, the first manuscript provides an evaluation of conflict of interest policies at the 17 medical schools in Canada. The second manuscript provides an analysis of the culture of corporate science, informed by neoliberal ideology, through an examination of the extensive and pervasive roles of the drug promotion industry in clinical trial research, interpretation, writing, and publishing in medical journals. The third manuscript offers an evaluation of policies concerning FCOI relationships and industry involvement in CME development and programming adopted by 60 professional medical associations in Canada. The fourth and final manuscript comprises an quantitative analysis of FCOI relationship disclosures in Canadian clinical practice guidelines. In general, these evaluative efforts found that the policy environment concerning industry involvement in various types of medical education in Canada is permissive and FCOI relationships are common among guideline authors. Positioned within the context of neoliberal corporate bias theory and Mertonian norms of science, these findings of general policy permissiveness indicate an alignment of goals between the pharmaceutical industry and medical education institutions. The necessity for increased transparency in terms of industrys roles in not only conducting, analyzing, interpreting, and publishing pharmaceutical research, but also data sharing is supported by existing literature on financial conflict of interest relationships with the pharmaceutical industry. Furthermore, the strengthening and enforcement of policies on industry involvement and FCOI relationships in these areas of medical education would help to ensure that medical education in the publics interest is achieved.
dc.identifier.urihttp://hdl.handle.net/10315/32735
dc.language.isoen
dc.rightsAuthor owns copyright, except where explicitly noted. Please contact the author directly with licensing requests.
dc.subjectMedicine
dc.subject.keywordsHealth policy
dc.subject.keywordsMedical education
dc.subject.keywordsConflict of interest
dc.subject.keywordsCOI
dc.subject.keywordsFinancial conflict of interest
dc.subject.keywordsFCOI
dc.subject.keywordsCanada
dc.subject.keywordsCanadian
dc.subject.keywordsMedical schools
dc.subject.keywordsMedical journals
dc.subject.keywordsProfessional medical associations
dc.subject.keywordsPMA
dc.subject.keywordsClinical practice guidelines
dc.subject.keywordsCPG
dc.subject.keywordsFinancial relationships
dc.subject.keywordsInstitutional policy
dc.subject.keywordsPharmaceutical industry
dc.subject.keywordsDrug company
dc.subject.keywordsPolicy evaluation
dc.subject.keywordsMedical research
dc.subject.keywordsStructural analysis
dc.subject.keywordsNeoliberal theory
dc.subject.keywordsCorporate bias theory
dc.subject.keywordsMertonian norms of science
dc.titleMedical Education and Financial Conflict of Interest Relationships with the Pharmaceutical Industry in Canada: An Analysis of Four Areas of Medical Education
dc.typeElectronic Thesis or Dissertation

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