In this first column on dealing with questions of moral principles and codes in the pharma industry, our writer posits that deciding what is ethical isn’t always a matter of what’s right and wrong.
As someone who has worked in academia and industry teaching ethics and is also a small business owner, I’ve developed a values-based business perspective regarding ethical issues in the pharmaceutical industry. Specifically, ethics is inseparable from good business practices and ethical practices should drive business decisions. However, recognizing what is ethical and what is not can be tricky. When confronted with ethical questions, deciding what’s ethical is like receiving advice from a wise rabbi: “It depends.”
Unlike many people, I find this answer to be particularly satisfying. “It depends” doesn’t paint you into a corner; instead, it allows room for ethical maneuvering. Consider the question, “Are You a Mac or a PC?” The logician would call this a false dilemma. “Mac” and “PC” aren’t the only answers. “Both” is a possibility. And so is depends.” As it turns out, I have Macs and I have PCs. I even have Macs running as PCs (thanks to some cool software). I have Flash- based eLearning development software and QuickBooks—they will only run on a PC. And I have creative suites of easy to use software that run on the Mac. So which system or piece of software I use depends on the context of the work I need to do.
As it turns out, the “Mac or PC” question is very relevant to ethics in the pharmaceutical industry. As human beings, we have a natural tendency to categorize things because doing that usually works for us. But beware the false dilemma. Ethics is not entirely a matter of simple “right” and “wrong.” Ethical thinking should begin with critical but also creative thinking. We need to use our moral imagination to expand the horizon or land- scape of potential answers (or hypotheses, if real answers are in short supply). We need, in short, to open our imaginative eye to see more clearly.
Again, ethics is not only about what’s right and what’s wrong. Most people know what’s clearly wrong, and they seldom make that their first choice. Movies and novels not withstanding, few people wake up in the morning and say, “I want to be unethical today.”
It is, however, sometimes difficult to determine what’s right. It’s even more difficult when we have to choose between competing values or choices. Both choices could be right. But there will be something—a value, an action, or a consequence—that makes us prefer one option. The remaining option isn’t wrong, necessarily; it just has less power to motivate us. This is where moral imagination, with careful consideration of the facts and an appropriate ethical framework, can assist us in resolving ethical difficulties.
Limiting choices constrains cooperation, dialogue, and problem solving—all of which are necessary to be properly ethical. Future columns will explore the moral imagination, the use of critical and creative thinking skills, and ethical frameworks. We’ll tackle how to open up our usual way of thinking about ethics as it relates to the pharma industry: Right and wrong, good and bad, should and could, and other dipoles. Using our moral imagination will help us open up our ethical viewpoints and perspectives. And by building opportunities to exercise this imagination in the frameworks we use to analyze problems in ethics and compliance, we can also avoid the pitfall of the false dilemma.
David Perlman is a visiting professor at the University of Sciences in the Mayes College of Healthcare Business and Policy in Philadelphia, PA. He teaches courses on ethical, legal, and policy issues in the undergraduate and graduate business programs as well as in the health policy and public health program.