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Compass Newsletter Masthead
   Volume I, Issue 2
May 2005   

Bioethics and the drug industry

Panel moderator Rev. James McCartney, OSA, outlines knotty issues addressed in their book Health, Disease, and Illness.
On April 11th Falvey Memorial Library hosted an engaging discussion on the changing realities of medicine and our modern concepts of health and disease. Based on their book, Health, Disease, and Illness: Concepts in Medicine (Georgetown UP, 2004), the three editors, Arthur Caplan, Rev. James McCartney, OSA, and Dominic Sisti were joined by Barbara Ott, RN, and Timothy Kirk to discuss some fundamental moral questions related to the modern pharmaceutical industry.

Father McCartney, an associate professor in the philosophy department at Villanova University, addressed how the values and attitudes of a period often pervade scientific study in that era. As an example, in the 1850s the medical term “drapetomania” referred to a “disease” found among black slaves in the United States whose main symptom was a desire to escape from their masters.

Arthur Caplan, the Hart Professor of Bioethics at the University of Pennsylvania, describes the bioethical implications of Pfizer’s blockbuster drug, Viagra

Dr. Caplan, the Hart Professor of Bioethics, University of Pennsylvania, then discussed how Pfizer had to “invent a disease” when researchers accidentally discovered the side effects of a pill designed to control high blood pressure. The pill in question was Viagra. According to Caplan, the “Christian-based” company faced a dilemma of how to successfully market this new pill without damaging their image. The answer was to invent the disease “erectile dysfunction” and aim their promotional campaign at older, married men who wanted to enhance an already happy marriage. However, as the market for older men shrunk, advertising targeted younger men who wanted an improved sex life. The earlier ethical concerns about the company’s image were no longer a factor as drug sales were now driven by the business side of the company.

Dr. Ott, associate professor, Villanova University College of Nursing, discussed how menopause changed from being considered a natural aspect of life to being labeled a “disease.” Hormone replacement therapy was promoted as the cure to save middle aged women from the discomfort of hot flashes, forgetfulness, sagging skin and loss of sexual desire. It was insinuated that women would outlive their usefulness if they did not use HRT.

Dr. Kirk, visiting assistant professor of philosophy and ethics at Villanova University, suggested that several social forces are involved in the development and manufacture of medicines. Companies consider how big a health problem exists for the disease, how many people who suffer from the disease are able to pay for this medicine, what other options are available to treat the disease, such as psychological counseling, and who is developing the medicine. Companies with few females in powerful positions are slow to develop new medicines geared to women’s health care.

The final panelist, Dominic Sisti, a researcher at the University of Pennsylvania Center for Bioethics and adjunct instructor at Villanova University, explained how powerful political interests have gotten involved in the funding, development and marketing of new medicines. Often pharmaceutical companies become stakeholders, gathering support by contributing large amounts of money to social and charitable agencies concerned with a problem, as with attention deficit disorder. An aggressive marketing blitz, along with journal articles and explosive news stories, will substantially increase their drugs’ sales. This blitz can be misleading and create potential adverse effects such as misdiagnosis of normal behavioral patterns.

The panel agreed that one significant role of the bioethicist in the 21st century should be to monitor the pharmaceutical industry by serving on advisory boards, becoming more involved in research ethics, raising important questions and bringing needed values to the table.

Darren Poley, programming coordinator, introduced the panel, and Bente Polites, librarian liaison to the philosophy department, organized the event.

Susan Markley is librarian liaison to the College of Nursing; photographs are by Katy Lee.