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In a series of studies, the Sunday Review investigated how would-be whistle-blowers make this decision. In the study a group of 74 research participants were asked to write a paragraph about an occasion when they witnessed unethical behavior and reported it and another group, of 61 participants, were asked to write about an occasion when they witnessed unethical behavior and kept their mouths shut. The answers indicated that the whistle-blowers used 10 times as many terms related to fairness and justice, whereas non-whistle-blowers used twice as many terms related to loyalty.
The research revealed that whistle-blowing brings two moral values, fairness and loyalty, into conflict. Doing what is fair or just often conflicts with showing loyalty. Even though fairness and loyalty are both basic moral values, people tend to prioritize one over the other. Part of what makes decisions about right and wrong so difficult for society is that we don’t all go about it in the same way. Such diversity in how we decide reflects the rich tapestry of resources we each bring to our decision making. Although some may argue for good results and others for following the rules, one thing is certain: Ethics is always more than just what we might like or dislike, always more than a rash opinion. What ethics requires of us is making judgments that we can explain, making judgments that rely not on opinion but on results or rules or good habits. We need to remember that how we decide is just as important as what we decide. Simply stated, ethics refers to standards of behavior that tell us how human beings ought to act in the many situations in which they find themselves-as friends, parents, children, citizens, businesspeople, teachers, professionals, and so on. The following case of Pharmacia a pharmaceutical company address the dynamics of whistle blowing as an ethical issue.
The case is about some whistle blowers right to receive compensation after reporting a Federal False Claim Act against the pharmaceutical company Pharmacia for the drug Genotropia. Dr. Peter Rost is the Vice President of Marketing for Pharmacia (which was acquired by Pfizer in 2003) he is aware that the pharmaceutical company is encouraging physicians to prescribe the drug for unapproved uses. Genotropia is a synthetic human growth hormone that is used to treat a limited number of hormonal deficiencies in children and the elderly. However, the drug company was using kickbacks in the form of all expense paid business sponsored conferences, paid participation in drug studies, and lucrative consulting positions to promote unapproved uses. These physicians were encouraged from 1997 to 2003 to use the drug for short children without any hormonal deficiencies and elderly patients as an antiaging therapy. These encouraged uses were not FDA approved for the drug Genotropia. Dr. Rost as head of marketing became aware of the misuse of the drug and protested to his supervisors. The company did curtail the incidents but not eliminate the practice. Pfizer in May 2003 acquired Pharmacia and made full disclosure of the illegal off-label promotional activities and within a few days prohibited them. Pfizer notified the FDA and other agencies with extensive documentation of the kickbacks as well as corrective actions that were being taken. Pfizer agreed to pay $35 million for bribery and improper promotions related to Genotropia.
Unknowingly, Dr. Rost in June 2003, files a complaint with the federal False Claims Act (FCA) after Pfizer had notified the agency. The FDA allows individuals to file and in return rewards a percentage of the recovered amount to the recipient which can range from 10 to 30 percent. The federal government requires the information be from personal experience that has never been publicly disclosed, in other words it must be the “original” source and must have “direct and independent” knowledge. After review by the FDA of the documents presented some were questionable findings. He did not provide solid evidence of his claims that Pharmacia had encouraged doctors to perform one test for a diagnosis of growth hormone deficiency where two tests were required. He also did not prove the physicians were targeted by promotional activities. This cost him job retribution and he was eventually fired. Being a whistle blower has its drawbacks as in this case Dr. Rost made his decision to disclose the information he had obtained. The emotional and personal nature of ethical decision making can present difficulties, and conflict can arise when people have different ethical perspectives. An understanding of ethical terms and ethical theories can be helpful in clarifying the source of this conflict. These may include prominent ethical theories such as moral relativism, utilitarianism, Kantian absolutism, Aristotle’s virtue ethics and ethics of care, as well as the key ethical principles in healthcare (autonomy, beneficence, no maleficence, and justice).
Adopting a step-by-step approach can simplify the process of resolving ethical problems. In conclusion, “When all is said and done the whistle blower must blow the whistle for the right moral reason and reasoning. ” Some believed whistle blowing “violates a prima facie duty of loyalty to one’s employer. ” Others argues that “whistleblowing involves a betrayal of the employer’s interests by the employee in the interests of the public good. ” When relating to ethical behavior the whistleblower must make a tragic moral choice, whom to betray, the employer or society.
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