The Practice of Pharmaceutics and the Obligation to Expand Access to Investigational Drugs

Journal of Medicine and Philosophy 45 (2):193-211 (2020)


Do pharmaceutical companies have a moral obligation to expand access to investigational drugs to patients outside the clinical trial? One reason for thinking they do not is that expanded access programs might negatively affect the clinical trial process. This potential impact creates dilemmas for practitioners who nevertheless acknowledge some moral reason for expanding access. Bioethicists have explained these reasons in terms of beneficence, compassion, or a principle of rescue, but their arguments have been limited to questions of moral permissibility, leaving for future research the question of whether expanded access is morally obligatory. We take up this further question and argue that pharmaceutical companies have a moral obligation to expand access. Our defense is not based on beneficence, compassion, or rescue, but instead on a reciprocal moral expectation resulting from existing social commitments that help ensure a robust pharmaceutical practice within the broader healthcare system. Our aim is to give this obligation, along with several others, a coherent and plausible structure within the wider clinical trial process so that one might better explain the sources of the dilemmas and their possible resolutions.

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Author Profiles

Collin O'Neil
Lehman College (CUNY)
Michael Buckley
Lehman College (CUNY)

References found in this work

Justice as Fairness: A Restatement.John Rawls (ed.) - 2001 - Harvard University Press.
Justice as Fairness: A Restatement.C. L. Ten - 2003 - Mind 112 (447):563-566.
The Idea of Human Rights.Charles R. Beitz - 2009 - Oxford University Press.
Collected Papers.John Rawls - 1999 - Harvard University Press.

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Citations of this work

The Ends of Medicine and the Experience of Patients.D. Robert MacDougall - 2020 - Journal of Medicine and Philosophy 45 (2):129-144.
Considerations of Conscience.Bryan Pilkington - 2021 - HEC Forum 33 (3):165-174.

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