II Dispensing

Patient-Centered Care or Drug-Centered Care: The Influence of Pharmaceutical Marketing on Medical Science and Public Health

Howard Brody

Introduction

“Patient-centered care” has become a popular buzzword, leading to concerns that it is being used as pure public relations without substance. When it does have substantial content, it can best be understood in contrast to other sorts of “care” (Duggan et al. 2006). When contrasted with “doctor-centered care,” patient-centered care refers to allowing a robust role for patients to be involved in decisions regarding their own healthcare, rather than simply being expected to follow the professionals’ directives and recommendations.

Alternatively, patient-centered care could be contrasted with “disease-centered care.” It treats patients as fellow human beings in distress and in need of aid and not merely as bodies that encase diseased organs in need of technical fixing.

Patient-centered care then refers to a style of care that takes seriously the human beings who are sick and incorporates a full appreciation for their feelings, thoughts, values, and social relationships.

The major question I wish to discuss in this chapter is whether there remains a further contrast to patient centeredness in medicine and healthcare, which we could term drug-centered care. Drug-centered care is what results from the influence of pharmaceutical industry marketing practices over the thinking and activities of both physicians (and other health professionals) and patients. From the standpoint of a drug company, seeking to make a profit in a capitalist economy by selling a useful product, drug-centered care makes a lot of sense. But we must ask whether it makes sense from the standpoint of medical science or public health. To aid in this inquiry, I shall look in more depth at two case studies—medications for depression and for type 2 diabetes.

H. Brody (*)

The University of Texas Medical Branch, Galveston, TX, USA e-mail: This email address is being protected from spam bots, you need Javascript enabled to view it

© Springer Science+Business Media B.V. 2017

D. Ho (ed.), Philosophical Issues in Pharmaceutics, Philosophy and Medicine 122, DOI 10.1007/978-94-024-0979-6_7

Patient-centered care, understood as something substantive, can be defended on at least three ethical grounds—it has been shown to produce superior health outcomes in patients; it better respects the personal dignity and basic rights of patients; and it instills virtuous attitudes in health professionals (Duggan et al. 2006). If these ethical goods are to be achieved, we have to ask whether drug-centered care promotes these outcomes or interferes with them.

 
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