Intersection, co-dependence and tension: The no-man’s land between medicine and pharma

Dr Wendy Lipworth1, Professor Miles Little1, Professor Kathleen Montgomery1,2

1University Of Sydney
2University of California


Medicine is deeply intertwined with the pharmaceutical industry, and much medical practice, research and policymaking takes place at this intersection. While connections between medicine and the pharmaceutical industry are strongly supported by some medical professionals, others worry about the corrupting influence that the industry has over doctors, researchers and policymakers. There is, of course, nothing wrong with ongoing disagreement about such a morally and politically complex issue, but participants in debates about industry influence have become entrenched in their views and dismissive of those who have opposing views. This both stifles progress in the management of industry influence and is likely to be confusing to the majority of practicing medical professionals who are simply trying to get their work done in an increasingly commercialized biomedical environment. One way through this impasse might be to generate a deeper understanding of the values of people on both sides of these debates, looking for areas of similarity as well as difference, and for key issues that remain unresolved. With this in mind, we conducted a qualitative analysis of a recent debate about industry influence and interactions that was triggered by a series of articles in the New England Journal of Medicine. Our results show that, while there is at least a degree of compatibility between the value systems espoused by the two groups, there are also a number of profound socio-political and epistemic points of difference. While it is unlikely that these differences will ever be completely resolved, our results do point to some implicit agreements and to a series of steps that might be taken in order to advance debates about medicine and the pharmaceutical industry.


I am a medically trained bioethicist and health social scientist, and Senior Research Fellow, at the Centre for Values, Ethics and the Law in Medicine, University of Sydney. My program of research focuses on the ethics and politics of biomedical (especially pharmaceutical) innovation.

My work is premised on the view that controversies about biomedical innovation are not just “technical” or organizational. Rather, they are about values and politics. I therefore use methods of “empirical bioethics” in which empirical research into the values of all key stakeholders is used in conjunction with theoretical analysis in order to address real-world problems.