illustrative of the above, the beginning paragraphs of an article from
the NYTimes:

http://www.nytimes.com/2005/09/22/business/22devices.html
September 22, 2005
Possible Conflicts for Doctors Are Seen on Medical Devices
By REED ABELSON
As an assistant professor at the Louisiana State University Health
Sciences Center in Shreveport, Dr. William Overdyke oversaw operations
to replace worn-down knees. From 2000 through the middle of 2001,
whenever a patient needed an artificial knee, he or the residents he
supervised implanted one made by Sulzer Medical, state documents show.

Dr. Overdyke has said that he used the Sulzer implant because it was
the best available. But Louisiana state officials say he had another
incentive as well: the $175,000 a year that he stood to make from
contracts with the company. The contracts called for him to consult on
product design and "promote and educate other surgeons" on the virtues
of Sulzer products.

Before signing with Sulzer, Dr. Overdyke said, he had never used the
company's artificial knee. Earlier he had a contract with another
company, Wright Medical. And during that time, he and his residents
largely used Wright's artificial knees.

Dr. Overdyke paid $10,000 in fines after investigators determined that
his consulting arrangements with Sulzer were an improper conflict of
interest under the state ethics code. Hospital officials said they had
been unaware of his relationship with the company.

Yet in a variety of ways, many doctors have unusually close, if largely
unseen, ties to device makers. And those relationships are a central
issue on an emerging battleground in the health care wars: the upward
cost spiral of implantable medical devices.

Countless patients have been helped by these new technologies -
artificial knees that allow aging weekend athletes to play on, stents
that help keep once-clogged arteries clear, defibrillators that correct
potentially fatal heart arrhythmias.

But the rising cost of the devices and the relationships between
doctors and manufacturers are causing profound concern among hospital
executives, health care economists and other experts, mirroring recent
reactions to the way pharmaceuticals are marketed. In the last two
years, Medicare payments to hospitals for implant surgery have risen
about 40 percent, from $10 billion to $14 billion, according to an
analysis of Medicare records. And federal prosecutors have begun to
investigate some device makers' deals with doctors, trying to determine
if they amount to payoffs for using a product.

Among the loudest objectors have been hospitals, which buy the devices
and most immediately feel the pain. But health care economists stress
that consumers and insurers are also hurt by the rising cost of medical
technology, including implantable devices.

"We're paying for it, but no one can see it," said Paul Ginsburg,
president of the Center for Studying Health System Change, a research
group in Washington.

Once medical ethics included the avoidance of any situation that might offer
even the impression of impropriety.

What has happened to that ethic?

And where are the ethics of those who would argue for such situations?