english.prescrire.org > Positions > Ethics > Values

Theme: Ethics

The world of healthcare abounds in grey areas. As the lines blur between treatment and research, between innovation and progress, between patient and consumer, ethics must remain at the forefront of healthcare education and information. 


The development of OTC drug sales in French pharmacies is just one stage in the long process of deregulating and commodifying healthcare, in the name of "freedom of trade" or "economic growth". It is time to stand up for other values: "patients’ interests," "solidarity", "public health" and professional "independence".

The French government has authorised over-the-counter sales of certain drugs in pharmacies. The authorities are communicating with the public, in the promotion of "self-medication". Other voices call out for "growth to be unleashed" and for the public to be allowed to "at last" buy medicines at the supermarket, in the name of progress and lower prices. In France and in Europe, yet other voices call out for "freeing capital" and allowing new investors to enter the healthcare field, from pharmacy chains to laboratories, and even medical practices. Why, they ask, do we restrict the "freedom to invest"?

In France, these measures, proposals, announcements and rumours all seem to get the attention of policy makers. They serve to remind healthcare professionals, especially physicians and pharmacists, that their future, including their financial future, is not guaranteed, with all that this implies in terms of professional independence. Healthcare professionals may soon have to report to new "bosses", whose principal motivation is not improving public health. And many healthcare professionals have noted that economic liberalism and public health do not always go hand in hand, once certain limits have been passed. These limits must be defended, no matter what.

It was time we all became aware of this. Prescrire sometimes felt it received little support when speaking out against a government, agency or European Commission project or policy that was too favourable to influential special interests, especially pharmaceutical companies. The development of OTC drug sales in pharmacies is a response to the repeated request from pharmaceutical companies to "free" their growth, and the authorities, who want to "free" the market for drugs not paid for by the public healthcare system. This is just one stage in the long process of the deregulation and commercialisation of healthcare.

Healthcare professionals will need to defend values other than "freedom of trade" or "economic growth". They will need to defend "patients’ interests", "solidarity", "public health" and professional "independence". These values are also very important to other sectors of the population.

Let us dare to stand up for these values, together.

©Prescrire 2008

Source: "Valeurs" Rev Prescrire 2008; 28 (299): 641.