On Physician–Industry Relationships and Unreasonable Standards of Proof for Harm: A Population-Level Bioethics Approach

The primary claim of this paper is that a widely used argument against obstructing, curtailing, or eliminating deep physician–industry relationships is deficient. The typical argument critiqued requires that proof that physician–industry relationships cause harm flows from randomized controlled trials. Chief among the deficiencies in this claim is the fact that this specific demand for proof of harm essentially guts the precautionary principle. In so doing, the typical argument neuters the basic justification for public health action. In place of this fallacious move, the paper argues that proof of harm can be demonstrated via evidentiary standards widely accepted within the knowledge communities of public health scientists and epidemiologists. The paper concludes by noting that while there may be good reasons to oppose curtailment of deep physician–industry relationships, the typical argument described here is not among them.