Pharmaceutical Ethics and the Opioid Crisis
1) What’s the Ethical Dilemma?
How drug companies like Purdue Pharma (maker of OxyContin) and Insys Therapeutics (maker of Subsys, a fentanyl drug) chose to sell more drugs by using lies and tricks, even though they knew those drugs were dangerous and addictive.
These companies had a choice:
- They could be honest about how risky the drugs were and try to help people in pain responsibly,
- OR
- They could hide the truth, use sneaky sales tactics, and push the drugs really hard to make more money. (Chosen)
They paid doctors to prescribe their drugs, gave false information to insurance companies, and pushed people who didn’t really need opioids to take them. This caused a national health crisis, with hundreds of thousands of people becoming addicted or dying from overdoses.
The ethical dilemma was: should they do what’s right and protect people, or lie and make money? They chose to make money, and the result was a huge tragedy.
Corporate culture: honesty, openness.
2) Who Are the Stakeholders?
All the people or groups affected by what happened. In this case, there were many:
- Patients – People taking opioids. Many were in pain and trusted their doctors. They received dangerous drugs that led to addiction, overdose, and death.
- Families and communities – These people lost loved ones, dealt with addiction at home, or saw their towns suffer from crime, poverty, and drug abuse caused by opioids.
- Doctors – Some were bribed by drug companies to prescribe more opioids. Others were misled about how safe the drugs were and unknowingly gave patients something harmful.
- Pharmacies (like CVS and Walgreens) – Filled large numbers of opioid prescriptions, even when there were red flags, like many cash payments or the same drug going to multiple people at the same address.
- Pharmaceutical companies (Purdue, Insys) – These companies made and sold the opioids. They made decisions to push sales at any cost.
- Sales reps – Employees who were paid bonuses for getting more doctors to prescribe opioids. They were told to focus on “pill mill” doctors who gave out lots of prescriptions.
- Insurance companies – They were lied to by drug company employees pretending to be medical staff. This caused them to pay for opioids that people didn’t actually need.
- Government agencies (like the DEA) – These groups are supposed to protect people from dangerous drugs. They tried to step in, but in many cases, they acted too late.
- Consulting firms (like McKinsey) – They helped Purdue come up with ways to sell more opioids, even though they knew people would get addicted.
3) What Values Were Affected?
Honesty – Drug companies were not honest. They told doctors and the public that opioids were safe when they knew they were addictive. They lied to insurance companies to get drugs paid for.
Responsibility – Companies had a duty to keep people safe, but they chose to ignore the harm. They did not act like responsible businesses or healthcare providers; they acted in their own interest and let people suffer.
Integrity & Respect – These values were violated throughout the process.
4) Top-Down or Bottom-Up Process?
Top-down process. The unethical actions — like bribing doctors, faking insurance calls, and targeting high-prescribing doctors — all came from executives and managers at the top of the company. They created the strategies and told their employees to follow them. Lower-level employees may have followed even if they felt uncomfortable; decisions were made by people in power who cared more about profits than people. The workers just followed orders.
5) Did Their Ethical Thinking Influence Decisions?
Yes, but in a bad way. Their thinking was selfish and short-term. They didn’t ask, “Is this right?” They asked, “How can we make more money fast?”
They used a way of thinking that said: “If we sell more, we win—even if people get hurt.” This is the opposite of good ethical thinking. They didn’t follow basic values like honesty, kindness, or respect for human life. They focused on profits and power, and ignored the fact that they were destroying lives.
6) What Was the Ethical Issue, How Serious Was It, and What Caused It?
Ethical issue: Drug companies lied and pushed dangerous drugs just to increase their sales. They hurt people on purpose by doing this.
How serious was it: Extremely serious. Over 450,000 Americans died from opioid overdoses. Families were destroyed. Communities fell apart. Millions of people suffered from addiction.
Caused it: It started when companies like Purdue and Insys wanted to increase sales, so they used tricks, paid off doctors, and ignored warnings about addiction. Their choices were greedy and careless.
7) Was the Code of Ethics Followed? Were Rules Broken?
No, the Code of Ethics was not followed. These companies promised to protect patients and act honestly, but they did the opposite. They broke laws, lied to insurance companies, bribed doctors, and sold dangerous drugs without caring about the consequences. Because of this, companies like Purdue and Insys lost public trust. They were sued, fined billions of dollars, and some of their executives were sent to prison. Pharmacies like CVS and Walgreens were also affected. People saw that they had failed to stop suspicious sales, and they had to pay huge fines too.
8) What Would I Have Done? What Way of Thinking Would I Follow?
1) The company would be honest about the dangers of opioids.
2) Doctors would be trained properly on how to prescribe them safely.
3) Sales would be based on helping people, not on making money.
I would follow a way of thinking called deontological ethics, which means doing the right thing no matter what, even if it means less money. I would believe that telling the truth matters, people’s lives matter more than profit, and laws and values must be followed.
That way, the company could still help people in pain, without lying, cheating, or causing harm.