If Dr. Arie Figer, head of the gastroenterology service at Tel Aviv's Sourasky Medical Center's oncology institute, is indicted on suspicion of bribery and other criminal acts related to clinical trials, patients and drug companies, the Israel Medical Association will suspend him from membership.
Prof. Avinoam Reches, head of the IMA's ethics bureau, made the threat when asked to comment Thursday on the controversial oncologist.
Reches, who does not personally know the doctor who was this week arrested and questioned by police, said the IMA has never received any complaints from doctors or patients against him. The media have reported that after initial publicity, numerous other patients have contacted police to make complaints against Figer for allegedly demanding and receiving payments for including cancer patients in human trials.
"The accusations are not clear yet. The case suddenly was publicized, and we do not know what is rumor and what is true," said Reches. "I hope for him that accusations will be disproven. But if they are proven to be true - even some of them - then we will regard his actions as insufferable. I don't recall a case with such serious charges, but it could easily be a storm that ends with no evidence. However, if he's found guilty, it will be a stain on all doctors."
Patients, Reches said, "must never be charged for inclusion in clinical trials. It is a violation of medical ethics and a criminal act. Patients join clinical trials voluntarily because experimental treatments are given free throughout the trial and, if proven effective, until the drugs are put into the basket of services. If he sold drugs for clinical trials and charged patients for being included, this would be very serious. If he worked for companies that supplied the drugs to which he referred patients, it is illegal and both he and the company representatives must be tried."
Reches, a senior neurologist at Hadassah-University Medical Center in Jerusalem's Ein Kerem, said that the vast majority of doctors carry out clinical trials according to the declaration of principles prepared by the IMA.
He rejected the proposal made on Wednesday by Science and Technology Minister Ophir Paz-Pines whereby a law must be passed to regulate the relationship between physicians and pharmaceutical companies. The science minister said it was "forbidden for there to be a direct connection between a physician and a drug company. This must be illegal. The public must know how decisions are made, and there is nothing like transparency."
But Reches commented that "even if there were such a law, someone would violate it, just as someone may violate our guidelines. The IMA will not agree to a law that singles out doctors when there is no such legislation relating to the ethical behavior of journalists, architects, lawyers and other professionals. Doctors can be punished under existing laws against bribery and other criminal acts."
The IMA has set up a monitoring committee to determine whether any of its members have violated guidelines relating to free trips, weekends, gifts and financial benefits from pharmaceutical companies and other vested interests, Reches said. "We don't catch people, but we tell doctors the rules and accept complaints. We have disseminated the guidelines to all physicians, and we will continue to bring them to their attention."