AJPH -- eLetters for Aiello et al., 96 (11) 1910-1914

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HEALTH POLICY AND ETHICS:
Allison E. Aiello, Nicholas B. King, and B. Foxman
Ethical Conflicts in Public Health Research and Practice: Antimicrobial Resistance and the Ethics of Drug Development
Am J Public Health 2006; 96: 1910-1914 [Abstract] [Full text] [PDF]

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Ethics and Drug Development: Christian T. Stadtländer (5 December 2006)

Ethics and Drug Development 5 December 2006

Christian T. Stadtländer,
Microbiologist and Epidemiologist
University of St. Thomas, St. Paul, MN 55125
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Re: Ethics and Drug Development

ctstadtlande{at}stthomas.edu Christian T. Stadtländer

I read with interest the article by Aiello, King, and Foxman about antimicrobial resistance and the ethics of drug development (1). The authors used the example of methicillin-resistant Staphylococcus aureus (MRSA) to discuss the different viewpoints of drug manufacturers, physicians, patients, and the general public (1).
The viewpoints indicate competing interests with ethical dimensions between private and public entities. Pharmaceutical companies depend, like any other company, on revenues obtained from the sale of their goods and services to customers (2). There is nothing wrong with a company making a profit, but a problem arises when corporations put profits before human lives so that life saving drugs become nothing more than commercial products (3,4).
Ethical issues are a growing concern in societies around the world (5,6). Corporations as a whole as well as executives, managers, and workers as individuals, but also physicians and patients, are required to make ethical decisions to sustain our societies (5,7). The term “corporate social responsibility” has an important meaning in today’s global economy and means “sensitivity to the social costs of economic activity and to the opportunity to focus corporate power on objectives that are possible but sometimes less economically attractive than socially desirable” (5). Social responsibility can give a company a significant competitive advantage and is a prime business asset (2,5,7). Leisinger wrote that being a successful pharmaceutical corporation does not only mean being profitable, but also means raising the quality of life of sick people and avoiding costly hospitalizations (8). He sees the financial success of the pharmaceutical company as a result of market successes in the research, manufacture, and distribution of medicines of high social benefit (8).
Aiello et al. (1) believe that an approach of treating antimicrobials as public goods might be best in the long term in combination with public health prevention regarding infection control and management. This approach is perhaps suitable for MRSA. We should, however, also work towards changing the mind-set of the pharmaceutical industry by reminding corporations that they started their businesses to contribute to the common good by developing drugs and services for the improvement of human lives. Furthermore, we should discuss ethical issues of drug development more openly with all private and public entities, and demand a strong commitment to the highest values in public health (9,10). This way, we would be able to sustain our societies within a global environment on a much higher level, one that is more humane and beneficial to the sick among us.
References
1. Aiello AE, King NB, Foxman B. Ethical conflicts in public health research and practice: Antimicrobial resistance and the ethics of drug development. Am J Public Health. 2006;96:1910-1914.
2. Wheelen TL, Hunger JD. Strategic Management and Business Policy (8th ed.). Upper Saddle Rive, NJ: Prentice Hall, 2002.
3. MacDonald R. Drug company ethics. Br Med J. 2001;322:58.
4. MacDonald R, Yamey G. The cost to global health of drug company profits. West J Med. 2001;174:302-303.
5. Andrews KR. Ethics in Practice: Managing the Moral Corporation. Boston, MA: Harvard Business School Press, 1989.
6. Mackie JE, Taylor AD, Finegold DL, Daar AS, Singer PA. Lessons on ethical decision making from the bioscience industry. PLoS Med. 2006;3:e129.
7. Stadtländer CTK-H. Strategically balanced change: A key factor in modern management. Electronic J Bus Ethics Organiz Studies. 2006;11:17-25.
8. Leisinger KM. The corporate social responsibility of the pharmaceutical industry: Idealism without illusion and realism without resignation. Bus Ethics Quarterly. 2005;15:577-594.
9. Lansang MA, Crawley FP. The ethics of international biomedical research needs a commitment to high values in an open discussion with a variety of partners. Br Med J. 2000;321:777-778.
10. Coughlin SS. Ethical issues in epidemiologic research and public health practice. Emerg Themes Epidemiol. 2006;3:16.