To the Editor.
—Dr Westfall and colleagues1 consider the personal use of drug samples by physicians and office staff to constitute "a substantial gift from pharmaceutical companies" and that "the ethical implications... warrant further debate." Gifts to physicians from the pharmaceutical industry constitute a long-accepted tradition in the complex relationships between drug companies and the medical profession. Medical students are offered free books, free reflex hammers, free tuning forks, and a variety of other gifts. At medical conventions, physicians strolling through the exhibition halls are able to obtain gratis dozens of different items from pens to key chains, from calculators to watches, from tennis balls to floppy disks, from fresh juices to espresso coffee, and on and on.2Should these gifts be considered to constitute a bribe? Are these gifts given freely by the pharmaceutical industry with no ulterior motives? Although drug companies and biotechnology firms consider these gifts to be