Not for sale, not even for rent: just say no. Thoughts about the American College of Rheumatology adopting a code of ethics.

Medicine and industry have a special relationship. In many instances our interests are concordant and our interactions mutually beneficial. There are areas, however, where potential ethical and professional conflicts arise. Such an area is industry gifts and relationships. Gifts and relationships obligate. Acceptance of "gifts" or industry/commercial benefit(s) assumes obligations of grateful conduct, grateful use, reciprocation, and response. Increasing and compelling data document that industry support, gifts, hospitality, generosity, and other contributions clearly influence physicians. Physicians aspiring to the highest standards of professionalism will consider these issues in their personal conduct. Physicians with leadership responsibilities, and the organizations they serve, will eschew gifts and relationships and their inevitable conflicts. While these issues may seem difficult, I suggest they are really rather simple. As this is a time when so much is commercialized, when so much is for sale, when so little public confidence is left in our once noble profession, there is before us an opportunity to not compromise our ethics or our integrity, but rather assert the highest possible standards of professionalism, to remember that we serve our patients, and to champion their welfare. We should certainly not be for sale, not even for rent. We should say an emphatic "no." We should affirm our honor and integrity. The sages wrote "there are three 'crowns' (symbols of earthly accomplishment, stature, dignity, and respect): that of learning, that of priesthood, and that of royalty; but the 'crown' of a good name is the most exalted of all" (Talmud. Avot 4: 17). Let us individually and together, as the ACR, have a good name. Just say no.