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The Medical Marijuana Industry Needs a Code of Ethics

Last year Canada garnered global headlines when it made an historic shift to a federally legal, commercial medical cannabis industry. In the rush to establish new companies, produce consistent supply of quality products, and develop relationships with physicians and patients, the industry has failed to clearly articulate a common code of ethics.
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Last year Canada garnered global headlines when it made an historic shift to a federally legal, commercial medical cannabis industry. As a result, today our country finds itself at the epicenter of one of the world's newest, fastest-growing and most complicated industries.

In the rush to establish new companies, produce consistent supply of quality products, and develop relationships with physicians and patients, the industry has failed to clearly articulate a common code of ethics that reflects a non-negotiable commitment to serving the best interests of patients. This omission compromises the integrity of our fledgling industry at a critical moment as we work to build long-term legitimacy and overcome decades of social stigma and misperceptions.

Patients rightly expect that as producers of medicine we should hold ourselves to high standards. This is not practical without a code of ethics that is transparent, well-communicated and accepted by all stakeholders. Physicians and the pharmaceutical industry, as an example, comply with standards of conduct that detail acceptable practices. Detractors are monitored and sanctioned, if necessary. The same must be true for medical cannabis producers.

For months, Tilray has been urging the Canadian Medical Cannabis Industry Association (CMCIA) -- the current industry group representing Health Canada Licensed Producers (LPs) -- to adopt a Code of Ethics that mandates a verifiable commitment to safety, transparency, and avoidance of conflicts of interest. Unfortunately, CMCIA and its members have to date declined to adopt such a code of ethics.

Perhaps more concerning than the absence of a code of ethics is the current practice undertaken by many LPs of paying kick-backs to physicians, either directly or indirectly, for patient referrals. To be clear: Tilray has never and will never compensate a physician for a referral or for writing a prescription for medical cannabis. Given the fact that accepting kick-backs is clearly prohibited by provincial regulatory bodies for physicians, we are surprised that this practice is so widespread.

For example, the College of Physicians and Surgeons of Ontario explicitly states that physicians "must not charge patients or licensed producers of dried marijuana for completing the medical document, or for any activities associated with completing the medical document, including, but not limited to: assessing the patient; reviewing his/her chart; educating or informing the patient about the risks or benefits of dried marijuana; or confirming the validity of a prescription." Yet we are aware of current CMCIA members who are paying doctors for engaging in all of the above practices.

Patients are best served when treatment choices are made without financial influence or incentive. Our objective as LPs should be to produce the highest quality product and support efforts that enable the patient and their physician alone to make an informed choice on the best medical cannabis strain for their individual medical need. It is extremely concerning to us that CMCIA has failed to prohibit kick-backs, an issue which has already been decided as a matter of policy by the provincial Colleges of Physicians.

When Health Canada established the Marihuana for Medical Purposes Regulations in 2014, it created the most stringent set of medical cannabis guidelines in the world. We knew then that we needed strict regulations to help ensure patients receive medicines that are safe and reliable. We know now that we also need exacting standards to ensure patients benefit from both the letter and spirit of the law.

For these reasons, it is with great disappointment that Tilray has been compelled to terminate our membership with CMCIA. Instead, we will spearhead the establishment of the Canadian Medical Cannabis Council (CMCC), a new association that recognizes our collective responsibility to help assure ethical behaviour from the entire medical cannabis supply chain. The new association's code of ethics is based on six fundamental and non-negotiable principles: integrity, safety, quality, access, security and research.

The medical cannabis industry has been tainted with misinformation and negative stereotypes that have been perpetuated by the low ethical standards accepted by the industry. Our efforts to investigate and demonstrate the therapeutic value of medical cannabis are consistently undermined by industry players who regularly choose incentives over integrity.

An unwavering commitment to ethics is the only viable way to build patient trust and establish our industry as a legitimate contributor to Canada's health care system. CMCC reflects a long-term, resolute commitment and accountability to patients. All medical cannabis licensed producers and stakeholders are welcome to join as members as long as they commit to advancing the science, safety and efficacy of medical cannabis for patients and physicians in Canada and around the world in accordance with CMCC's Code of Ethics. As the first member, we are confident that others will realize the long-term value of the Code of Ethics and join CMCC.

For more information about the Canadian Medical Cannabis Council visit www.cmcc-cccm.ca.

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