01 October 2013

Medical and nutrition ethics, anyone?

On September 8, 2003, The Nation revealed that the Sri Lanka College of Paediatricians (SLCP) had obtained sponsorship from Fonterra, which although perfectly legal compromised the integrity of the College due to the implied endorsement of all Fonterra products.  Suspicious indeed was the fact that Fonterra did not name itself (why?) but instead used advertising elements used in PediaPro (its flagship infant milk food product) promotions in branding the Annual Scientific Congress of the College.  

The College, responding to a query by The Nation said that a complaint had been lodged with the Press Council on that story. The Nation is surprised that the College has not availed itself of ample opportunity to provide answers to a set of very simple questions put to it.
Here are the questions again:

Does this amount to the College of Paediatricians officially endorsing PediaPro? Does this not compromise the College from offering independent and professional opinion on PediaPro or any Fonterra brand in the event of suspected wrongdoing including unethical advertising? Does the College have sponsorship and endorsement policies, and if so what are they?  

That was an opportunity to state position on sponsorship, endorsement and unethical advertising.  It is not too late. 

The Nation does not have an axe to grind with any professional association. Indeed, it is in the interest of both consumers and professional bodies to be clear about contentious issues such as sponsorship and endorsement.  In this, there needs to be clarity on the vexed matter of conflict of interest and the related issue of unambiguous disclosure. 

The Nation, earlier, raised similar questions with respect to the Nutrition Society of Sri Lanka (NSSL).  The NSSL maintained complete silence, even after we carried a clarification and asked a few follow up questions.  Debate and discussion, openness and professionalism, all of which are taken as givens in bodies such as the NSSL and the SLCP, appear to be anathema to them.   

Do such organizations prefer to be insulated from all scrutiny and remain within comfortable professional walls wherein they can dish out consumer advice to a largely ignorant population that (still) hold certain categories of professionals such as doctors in high regard, we wonder. 

Perhaps this is the time to broach the subject of medical and nutrition ethics.

The Nation, for its part, has highlighted important issues which we believe the consumers need to be aware of.  In the spirit of fairness, we have always accorded the opportunity for all relevant stakeholders to offer comment and critique and this, most importantly, in a media culture that for a multiplicity of reasons, where corporate entities are treated as holy cows.  That culture, we believe along with many professionals and consumer rights activists, needs to change. 

We believe that a responsible and ethical media outfit is compelled to talk about unethical sponsorships and issues of conflict of interest. The public has a right to such information. Silence and secrecy, cute and clever advertising with subliminal messages is unethical; acceptance of sponsorship from entities that have no qualms about such practices is unprofessional.  Again, if either of the organizations mentioned above or anyone else for that matter wish to take issue with the contention, the pages of The Nation are open to them. 

In this regard it is important to note that although the Sri Lankan consumer may be kept in the dark by all and sundry, in Western nations and also in neighboring India there are many consumer lobbies and others that expose and also oppose the unethical practices of the so-called professional associations. It is now common practice to publish sponsorship details of the professional associations on the internet for the perusal of any interested party. There are websites that routinely publish critical evaluation of sponsorship acceptance of professional associations and other unethical activities. Any professional association that balks from scrutiny is naturally the subject of suspicion. 

The Nation firmly believes that professionals have an important role to play, especially given an overall institutional arrangement which does no insulate citizen from politician.  This is why, we make three simple requests to the President and the Council of the College of Paediatricians for the benefit of the public. Firstly, kindly publish the sponsorship details (i.e. sponsors, financial and other perks received) of the College for the last ten years.  Secondly, publish the evaluation criteria used by the College to evaluate the products of the sponsors (if such criteria are non-existent, please explain why not).  Thirdly, we urge the College to publish the scientific position of the College (i.e. ‘Position Papers’) regarding PediaPro and similar products on the market or, in the event that such position is absent, explain why (by implication) mechanisms don’t exist to arrive at positions, one way or another.

Millions of consumers (and medical professionals) are in the dark. Therefore, the College has a serious, professional and a moral obligation, we believe, to enlighten the members of the public that takes the word of the medical profession and the scientific community unquestioningly and with absolute faith. We will be very willing to provide space for such publications. This will afford the readers an opportunity to make their own determinations with regard to ethics, integrity and professionalism and moreover whether or not such entities are working in the public interest.