Abstract
The morale of the medical professional is at an historic low in many countries. The recent case of a UK general practitioner being convicted of being a mass murderer, combined with increasing criticism of medical negligence and malpractice and an excessive influence of the large pharmaceutical companies has lead to the perception that the profession is under siege. Our professional leadership have not had sufficient public awareness to allay these concerns, and the resulting dip in morale is fast turning into a dangerous rout. We must review what has lead to this situation and what we should be doing now to put it right.Clinical research is under attack and the motives and ethics of large pharmaceutical company sponsorships of clinical trials is under increasing question. At this time there is a risk that medicine, and academic medicine in particular, will lose its attractiveness and the pace of achievements we have seen and benefited from in the last 2 decades may slow. The public debate should move on, it should move on to evaluate how much it would cost to reduce medical error rates to an acceptable level (to stop them altogether is impossible). It should move on to how we can get clinical trials designed and paid for by the public purse rather than merely grumbling that pharmaceutical companies take too much control of trials that they almost alone now appear to be sponsoring. And we should move on to debate about the role and status of the medical profession in the modern era. We can no longer do our best in secret and expect the public to trust us unquestioningly. The public wants and needs to be involved in our decision-making problems and errors. Only through informed debate will we improve health for the while population, now and in the future.
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