Code of Ethics

Interaction with the Medical Industry

The primary focus of the Orthopaedic profession is to provide excellence in patient care and the BOA expects its members to maintain the highest standards of professionalism, integrity, and ethical behaviour.  

It is recognised that collaboration between clinicians and industry is important in advancing and improving patient care. Industry often supports the development of new technologies, research, innovation and the continuing education of orthopaedic surgeons. It is clear in all commercial relationships that promotional expenditure and sponsorship can be used to influence the behaviour of individuals and it is in the interests of clinicians and the medical industry to ensure that this does not occur and that the relationship is totally transparent to outside inspection.

The UK Government has given specific advice upon the place of promotional expenditure and sponsorship in guidance issued relating to the new Bribery Act, which came into force in April 2011. The guidance suggests that “reasonable and proportionate promotional expenditure which seeks to improve the image of a commercial organisation, better to present products or services, or establish cordial relations, is recognised as an established and important part of doing business.” The act does not seek to criminalise normal and reasonable hospitality. Hospitality is unlikely to breach the Act if it is reasonable and proportionate, has a bona fide business purpose and is not intended to inappropriately influence an individual.

You can download the full BOA Code of Ethics. This document provides guidance on interation with the medical industry and contains a disclosure of conflicts of interest form.

Conflicts of Interest

The practice of medicine inherently presents potential conflicts of interest. There is nothing intrinsically unethical in finding oneself in a position of conflict of interest, however the conflict must be recognised and managed appropriately. When conflicts arise the interests of patients, whose ethical treatment is the primary focus of the orthopaedic profession, should always be placed above secondary gains.

Surgeons have an obligation to disclose any conflicts to patients, colleagues and/or the public. They must strive to resolve any interest by maintaining a professional relationship with patients and always acting in their best interest.

Relationship with Industry

A conflict of interest arises when a clinician, or an immediate family member, has a direct or indirect financial arrangement, positional interest or other relationship with industry, which could be perceived as influencing the clinician’s obligation to act in the best interest of patients.

A financial arrangement includes, but is not limited to:

• Compensation for employment
• Compensation from patients’ referral pattern
• Paid Consultancy, advisory board service etc.
• Share ownership or options
• Intellectual property rights (patents, copyrights, trademarks, licensing agreements, royalty arrangements)
• Paid expert opinion
• Honoraria, speaker’s fees
• Gifts
• Travel, meals, hospitality

A positional interest occurs when the clinicians or his/her family member has any form of relationship with a company with which the clinician has or is considering a transaction or arrangement.