In the USA, the American Medical Association has guidelines about gifts from the pharmaceutical industry incorporated in its Code of Ethics. These suggest that gifts to doctors should primarily benefit patients and should not be of substantial value. The American College of Physicians also suggests that a useful criterion for determining acceptability is whether doctors would “be willing to have these arrangements generally known”.

In Gibbons et al.’s study of attitudes to gifts from the pharmaceutical industry to doctors, only 62% of doctors were aware of any guideline about accepting gifts³⁴. Awareness of a guideline was the only predictor of doctors reporting that gifts were not appropriate. However these are self report data, so those who knew about guidelines may have felt more social pressure to say that gifts were unacceptable.

Drug samples, although not intended as gifts to doctors, may in fact be used in this way. Westfall, McCabe and Nicholas¹²⁴ found that in their family practice residency almost all staff, including medical practitioners, office staff etc had used samples provided by sales representatives for their personal or family use. The total retail cost of these was over US$10,000. As a result of their findings they instituted new controls over access to the medicine samples.

CONCLUSION: Not enough is known about the impact of guidelines for gifts to reach any conclusions.