It is well-known that technicians employed by commercial companies are involved in the maintenance of working on medical devices in hospitals. Unclear, however, is what exactly they do, what their relation with care providers is and what their rights and duties are. They play an important role in the use and maintenance of the often cutting-edge devices used in hospitals. They give instructions, train staff in the use of the devices, and may also be directly involved in patient care. But scientific research into the activities of these technicians, and their relationship with medical staff has been limited, and has so far not been done in the Netherlands. This article explains the need for greater awareness among Dutch care providers and hospitals, regarding the moral issues of the collaboration with employees of commercial companies in the hospital. The main aim is cost-conscious, clinically relevant and safe use of devices, without conflicts of interest.
- Technicians are employed in hospitals to assist doctors in the use of medical devices. The influence exercised by the medical devices industry on the costs and implementation of care often remains invisible and has hardly been investigated.
- In some cases, doctors cannot use a medical device without the assistance of a technician. This may lead to undesirable gaps in the doctors’ knowledge regarding decisions about the need for, and use of, a device.
- Research in hospitals in other countries than the Netherlands has shown that technicians working there may face moral dilemmas while carrying out their duties. It is unknown whether this is also the case in Dutch hospitals.
- Hospitals have a duty to clearly define the relations between technicians and care providers, and the associated responsibilities, and to make these known to the care providers and patients involved.
- Grundy Q, Hutchison K, Johnson J, Blakely B, Clay-Williams R, Richards B, Rogers WA. Device representatives in hospitals: are commercial imperatives driving clinical decision-making? J. Med Ethics. 2018;44(9);589-592.
- O’Connor B, Pollner F, Fugh-Berman A. Salespeople in the Surgical Suite: Relationships between Surgeons and Medical Device Representatives. PLoS One. 2016;11(8):e0158510.
- Mueller PS, Ottenberg AL, Hayes DL, Koenig BA. “I felt like the angel of death”: role conflicts and moral distress among allied professionals employed by the US cardiovascular implantable electronic device industry. J Interv Card Electrophysiol. 2011 Dec;32(3):253-61.
- Johnson J, Hutchison K. ’They know how to work it, that’s their focus in life’: the complex role of industry representatives in surgical innovation. J Empirical Res Human Research Ethics. 2018 Dec;13(5):461-474.
- Garliardi AR, Lehoux P, Ducey A, Easty A, Ross S, Bell C et al. “We can’t get along without each other”: Qualitative interviews with physicians about device industry representatives, conflict of interest and patient safety. PLoS One. 2017;12(3):e0174034.
- Sudarsky D, Charania J, Inman A, D'Alfonso S, Lavi S. The impact of industry representative’s visits on utilization of coronairy stents. Am Heart J. 2013;166(2):258-65.
- Garliardi AR, Ducey A, Lehoux P, Turgeon T, Kolbunik J, Ross S et al. Multiple constraints compromise decision-making about implantable medical devices for individual patients: qualitative interviews with physicians. BMC Medl Inform Decis Mak.2017;17(1):178. 17:178.
The literature refers to the Dutch text