1Name: ANH CHUNG Class: BETH 351 Quarter: SPRING 2012 Student ID: 1610851 ID: 1610851 2 Introduction: As we all know, AIDS/HIV is one of the most dangerous disease for human race. The number of people infected and dead because of AIDS is increasing year by year. Estimated there was 3 million people had died, 5 million people had infected with the disease, but that number was just within the United States. Meanwhile, at the sub-Saharan Africa areas, where 28 million humans being were living with AIDS, make it becomes the areas have largest number of infected people. Hundred thousand of families were destroyed by the epidemic, which left more than 11 million of orphans fend for themselves. Later, it is resulted in increasing in crime and decreasing in the agriculture. Before then, it was almost impossible for human to cure it. However, with the developing in technology and science, a treatment has been found. It is called the “cocktail”; it is a combination of three AIDS antiretrovirals drugs. The antiretrovirals medicine was researched and developed by big drug companies such as GlaxoSmithKline (GSK) and Bristol-Myers Squibb (BMS). GlaxoSmithKline is a British pharmaceutical company where Bristol-Myers Squibb is an American pharmaceutical company. According to the reported, both of the company’s revenue and profit are from 10 digits and up. Yet, a cure for HIV/AIDS is found, but the cost for treatment is expensive. It cost around $20,000 for a year of medicine. It also requires the doctors and nurse carefully monitored the patient, due to the complexity of the treatment. Furthermore, the patient has to take the medicine for the rest of their life. With such high cost, the patient from the sub-Saharan countries would never be able to afford it, because the mean annual income per person in these countries is only around $500. Even though, the cure has found, it was not applicable for people in sub-Saharan countries, ID: 1610851 instead of spending on expensive treatment. the treatment was too complicate for these countries to catch up with. According to the study. World Trade Organization (WTO) accepted an agreement. regardless the amount of drugs will be smuggled back. it was showed that the pharmaceutical company inflated the estimated investing cost by double the actual amount. However. developing countries had until 2006 to activate the ID: 1610851 .1 cents. Overall. they would not be able to produce any new medicine. compare to other in Fortune 500 companies. develop and bring the medicine to the market. Plus. they afraid that once they lower the price of the drugs. Furthermore. especially with their limited clinical resources. the drug companies did not want to lower the price to meet the needs of these low-income countries. However. Such as the big drugs companies had total profit about $36 million in 2002. the average return rate on equity of these companies is unusually high. to strengthen the protection to the patent of major drugs companies. Also.3 where millions of people were dying because of AIDS. which is called TRIPS – Trade-Related aspects of Intellectual Property rights. Whereas. the pharmaceutical companies suggested that these countries should use the money to develop the educational program to prevent the disease. other companies in Fortune 500 made 3. Furthermore. which accounted more than half of the total profit of Fortune 500 companies. In 1997. it was showed that: “the ten big drugs companies made 17 cents for every dollar in revenue”. They argued that. If they have to lower the cost. the critics have concluded that the big drugs company had the capacity to lower the AIDS medicine price for developed countries in need. they said it cost them tons of million to research. it will be transferred back to the developed country in an illegal way. Also. However. many doctors who volunteer to work in the poor countries and critics were not persuaded with the drugs companies. another three drugs company. In 2002 and 2003. GSK and BSM as well as other major drugs companies could not sue these companies. It is reported that only 300. After that. but for much lower price ($295. the numbers of people infected with AIDS keep increasing.4). they lower the cost again to $727. $209 and $201). the discount was not significant. there were only 50.1 million infected people received the antiretroviral drugs. “The CEO of GSK branded the Indian companies as “pirates” and asserted that what they were doing was theft even if they broke no laws” (article pg. a drug company name Cipla from India launched a copy version of antiretroviral “cocktails” AIDS medicine cost $350 for a year supply. to encourage the major pharmaceutical companies to lower their AIDS drugs for countries in need. Later on. however. Meanwhile. Therefore. Would this number of infected people as well of dying people changing if GSK and other major drug companies act differently? ID: 1610851 . and based on India’s patent law. Yet. it was still nothing compare to the India companies’ price. in the sub-Saharan countries. Since the TRIPS agreement was not effected India until 2006. GSK and BSM decided to discount the medicine down to $931. Due to the slow process and high cost in treatment. it was still too high for AIDS patients in the sub-Saharan and other developed-countries to purchase.4 TRIPS agreement.000 over 4. also from India introduced the same antiretroviral combination as Cipla. It is allowed to produce the medicine as long as it used a new process. Even though both GSK and BSM participate in the program and did lower the cost for their drugs.000 infected people in developed countries were receiving the treatment. United Nation establish a program called Accelerated Access Program. As the epidemic became a globally crisis. In 2001. Care and Virtue to examine this case. ID: 1610851 . Right. Justice. I will apply the five ethic theory – Utilitarianism.5 To determine whether the GSK’s effort to protect its intellectual property rights is ethical or not. 78). it is clearly that instrumental goods have a higher value than intrinsic goods. Despite of the fact that one’s happiness is hardly measured by the money value. identify the probable alternative actions or policies. ID: 1610851 . Utilitarianism is a general term for any view that holds that actions and policies should be evaluated on the basis of the benefits and costs they will impose on society (pg. and that we do what is best for everyone when we take into account all the benefits and harms that everyone will bear as the result of our action” (pg.6 Utilitarianism Theory To analyze the case using Utilitarianism theory. According to the utilitarianism. Some of these criterions are instrumental goods vs. “it is a theory that says that we should strive to do what is best for everyone in society. Last. it shows up some weakness that makes it hard to define and compare between the costs and benefits in present and future. The theory does not really give us the guide of how to measures and compares the action as utilitarianism requires. I will start with the definition. 85). Whereas intrinsic goods are: “things that are desirable independent of any other benefits they may produce” (pg.78). The utilitarian principle has three steps in analyzing an issue. 85). subtract the costs from the benefits for each action and pick the best net result. Second. The Utilitarian principle is easy to understand in term of theory. intrinsic goods and needs vs. the utilitarianism defends that they have standard measurements that can determine relative value. However. It also assumes that all human issues and concerns can be traded into an equivalent measurement. when apply the theory to a certain issue. first. Hence. Instrumental goods are known as: “things that are considered valuable because they lead to other good things” (pg. First. find the direct and indirect benefits and costs of each option for all affected parties. want. In this case. According to the article. Therefore. Furthermore. GSK claimed that the company had to spend $100 million to $500 million for the cost of doing research. they said that it would cost them so much that they will have to stop producing new medicine if they have to give away the AIDS antiretroviral drugs to the poor nations. Obviously. the alternative is GSK agrees to lower the AIDS antiretrovirals drugs price to meet the demand of the patients from the sub-Saharan areas and other developing nations. by deep discounting or giving away the drugs to unwealthy countries could harm GSK’s profit. we need to define the probable alternative then find the costs and benefits for each alternative. Millions of lives ID: 1610851 . it violates people’s right. However. by doing so it could actually benefits GSK by having no potential of heavy criticism from the society. the patients from the developing countries.7 Another issue with the utilitarian is it not always reflects the accurate decision in term of justice and fairness. From the standpoint of GSK. In a utilitarianism point of view. According to the guide line steps of Utilitarianism. the utilitarian principle gives the idea of as long as the majority group has the utility. it is morally right when it violate people’s right.2). And in some certain action it is ethical toward the Utilitarianism. development and bring the drugs to the market (pg. AIDS infected people from the sub-Saharan countries and developing countries would benefit directly when GSK deeply discount the drugs price. there are two parties involved for the ethical issue: GSK. GSK’s public image would be polished and honorable because of their public responsibility. Application: For this case. it is ideally to maximize the utility. But in fact. Therefore. then use the net benefit to decide which alternative to choose. GSK violated the Utilitarianism theory. If GSK reduce the drugs price to the affordable amount. which leaves millions of orphans have to survive for themselves.8 could be saved. upon weighing the costs and benefits for both parties. which leads to the destruction of these nations. For the cost that the GSK has stated. critics argued that these numbers are not accurate: “the figure of $500 million that drug companies often cited as the cost of developing a new drug was based on a study that inflated its cost estimates by doubling the actual out-of-pocket costs companies invested in a drug to account for so called “opportunity” costs (what the money would have earned if it had been invested in some other way) (article. all left is the determining the best net result of the alternative. Therefore. GSK’s loss would be less than what they claimed to be. As the alternative and the analysis of benefits and costs are done. ID: 1610851 . Result in increasing in crime.3). Therefore. once GSK accepted to deep discount or giving away the drugs for these nations. The only cost that the patients have to pay is the expense for their drugs. pg. For sub-Saharan countries. the best result for the society is to lower the cost of AIDS antiretrovirals drugs for the sub-Saharan countries. Yet. However. decreasing in agriculture production. that was not GSK action. 50% of the labor productivity in the subSaharan areas would regain and that would lift up the living standard as well as the annual income per-person more to than $500 a year. it would not be a major problem for the patients. in reality. most of the families were destroyed by the AIDS epidemic. With the inaccurate cost. ID: 1610851 . it implies that the reason for acting must be reversible.99). If not. “universalizability” means the reason for acting could apply for everyone. I choose to use Kantian rights to examine the issue. In doing so. For universalizability. but always treat them as they freely and rationally consent to be treated and help them pursue their freely and rationally chosen ends” (pg. which are the maxim. according to Kant. then using the maxim to apply for the two categorical imperatives. it is known as: “Never use people only as a means to your ends. After established the maxim. Moving to the second formulation of Kant’s categorical imperative. Also. it will apply to the two categorical imperatives. the ethical value would not be valuable. the two formulations weight the same in term of consideration. The first formulation of Kant’s categorical imperatives includes two criteria in examining moral right or wrong: universalizability and reversibility. it means: “The person’s reason for acting must be reasons that everyone could act on at least in principle” (pg. “A maxim is the reason a person in a certain situation has for doing what he or she plans to do” (pg. Whereas reversibility is explained as: “The person’s reason for acting must be reasons that that person would be willing to have all others use. Kantian rights have three elements. Also. In other words. It is crucial for people to be honest and consistent with the determination of the maxim.99). and two categorical imperatives. According to Kant. as Kant’s golden rule: “Do unto others as you would have them do unto you”.100). 99). even as a basis of how they treat him or her” (pg.9 Right Theory For Right theory. we allow people to develop their own capacity and recognize their dignity as a human being. First we develop the maxim. S and developed nations. The question is: is it acceptable for anyone to withhold the live-saving medicine from one that directly needs it. The maxim must be universalizable. which is not a major problem when compares to millions of lives living in the edge because the drugs supply is limited. my maxim for GSK is: In order to stay in business and protect their intellectual property rights of AIDS antiretrovirals drugs’ formula. they have four reasons that they did not lower the drugs price.6% of AIDS patients had developed drugs resistance”. Secondly. they did not agree with GSK’s point of view. it is acceptable for GSK to withhold the live-saving drugs from the patients in sub-Saharan countries. in order to protect their benefit? Not very likely. Last but not least is because they afraid that once they discount/give the drugs for free to the developing countries. ID: 1610851 . And if they have to lower the current antiretrovirals drugs price. they wouldn’t be able to produce new drugs.10 Application: With the given frame work. Therefore. The first one is because GSK argued that it’s better for the poor countries to use the limited resources on develop the education program to prevent the chance of getting infected with the virus. and the incapable to produce new drugs of GSK. according to the critics in this case. With the maxim is developed. At least. An amount of these drugs will be transferred illegally back to the U. GSK maxim cannot apply to universalize. According to GSK. the critics did not persuaded with the purpose to prevent the development of drugs resistance. I will start to apply to the first categorical imperative. they said that the treatment requires an advance medical technology and special care from the nurses and doctors to prevent the development of drug resistant. I will attempt to develop the maxim of the case. GSK argued that the cost to develop the drugs was too much. Research showed that “only 6. as a requirement of Kant’s categorical imperative. Thirdly. First of all. I will begin my analysis for the case base on Kantian rights. Hence. The last formulation of Kantian rights is to “never treat people as a mean but also as ends” (pg. the GSK executive wouldn’t agree with the reason that the native gave and accept that the child can’t be cured. no one’s freedom to choose can be sacrificed for the sake of the interests of others” (pg. It is not acceptable for the GSK executive to watch their kids die. However. Because of their intellectual property. it is obvious that GSK violated the second formulation as well as the first formulation of Right theory. Let’s imagine that when the child of the executive of GSK is diagnosed positive with the deadly disease and can only be treated from an herbal tree that only grows in a dessert. ID: 1610851 .11 I will now moving to the next part of the first categorical imperative – reversibility. Unfortunately.100). he/she is now in a defensive side. While. Cleary. GSK treats patients from developing countries irrationally and give them no option to “freely and rationally chosen to pursue” (pg. And the native in each area refuse to give the tree to the executive to cure his/her child. they don’t have enough money and rights to buy the medicine for their child. Getting back to the case. the GSK executive could not afford to buy the only medicine that can cure his/her child and have to watch the kid die day by day. again the maxim of GSK did not meet the reversibility requirement. Hence. Because they have to protect their intellectual right and preserve it for a person that affords the price that they set.101). 100). There are only a few of them are found in the world. the second formulation emphasis that “everyone is of equal value. Therefore. then how it is acceptable for other people. the parents of these children that infected with AIDS must have the same feeling when they can’t afford to buy the medicine for their child. GSK did not consider these patients are equally with the patients from wealthy countries. Hence. but takes steps to improve the position of the neediest members of society” (pg. The second principle in Rawls’ theory brings up an assumption that social and economic inequality is unavoidable in society. Basically.12 Justice Theory: “In general. And in that original position.116). 116). we will not bias our decision in principles that based on our favor. It states that “everyone should be given an equal opportunity to qualify for the more privileged positions in society’s institutions” (pg. Last but not least is the principle of fair equality of opportunity. he asked us to imagine a group of realistic self-interested people that have to choose the principles that they want to live by and in that society. John Rawls’ theory brings up a general method we can fairly evaluate many justice principles. 115). social standard and etc.115). Rawls calls that imagined situation the “original position” (pg. First of all. religion.115). without knowing how each of them are going to turn out in that society. the requirement that denies one’s knowledge about their bias tags such as sex. they will be administrated by these principles. With such conditions. Therefore. “With that in mind. everyone should be given an equal access to education and training needed ID: 1610851 . we have to determine principles that are good for all” (midterm paper). Also. job qualification should only relate to the job’s requirement and not involve any kind of discrimination. it set up standard non-compromised rights and these rights are protected from others by nature. Rawls’ first principle is called principle of equal liberty: “each person has an equal right to the most extensive basic liberties compatible with similar liberties for all” (pg. race. For instance. The first part of the second principle is called difference principles: “the claim that a productive society will incorporate inequalities. the goal of justice and fairness theory is to protect the least advantageous of a population. is called the “veil of ignorance” (pg. Patients from poor countries did not have the same treatment as patients in the rich countries.13 for the desired jobs. However. a person’s efforts. Because the cost for the medicine is too high. Yet it was not GSK choice. ID: 1610851 . Even though. Within the case context. Therefore. which is the partial of GSK toward the rich and the poor countries. while their annual income is significant low compare to the cost ($20. it goes against the principle of equal liberty. and unjust towards the unwealthy countries. the first principle is the most vital one and it should be consider at first. As Rawls mentioned. GSK defends that they have reason for that lower the medicine price. the patients from Sub-Saharan countries could not afford to buy the medicine from GSK as well as other major drug companies. abilities and contribution would then determine accomplished (pg.000/year vs. they only sell their medicine to countries that can afford it.115)” (midterm paper). It is clearly to see that GSK favors the wealthy countries. the reasons that GSK gave. the principle of fair equality of opportunity is violated. GSK was fully capable of discounting the drugs’ price for developing nations. Moving to the second principle. Hence. the principle of fair equality of opportunity has the similar key problems with the first principle. $500/year). the critics has shown that based on a study. Application: With the given justice principles. According to the case. Hence. Also it stated that GSK did not want to lower the drugs’ cost to meet the demand in these poor countries. I will begin to apply these guide lines to the case. it is important to consider the second part first – principle of fair equality of opportunity. where people must have their own rights and it is treated equally as others. it did not convince the critics. Furthermore. Therefore. GSK had committed an unjust act toward the patients from unwealthy countries. Let’s put GSK in the situation In summation. GSK was fully capable of lower the drugs’ price for developing nations. By not lowering the antiretrovirals drugs’ price for the patients in sub-Saharan. has proven to be unjust. Obviously. it is shown that ten big drugs companies had total profit in 2002 of $35. Rawls also mentions that “difference principle obliges us to maximize benefits for the least advantage” (pg. Yet it was not GSK choice.6 billion in profits netted by all other companies in the Fortune 500 list (Article pg. Hence.14 Though the difference principle does not weight as much compare to the other two principles. equal to more than half of the $69. Beside these moral principles. Therefore. GSK’s action breached all of the principle of Rawls’s theory. it is the most visible violation in the case. It not because GSK was not capable of discount the drugs price due to the research and develop cost. Based on a study.115). the way that GSK treated infected people from sub-Saharan countries in short and other poor countries by large. the principle of fair equality of opportunity is violated. GSK’s action goes against the difference principle.9 billion. GSK did not obligate to maximize the benefit for the least advantage. Rawls also talked about the veil of ignorance. ID: 1610851 .3). the neediest member in the society. But they are all connected together because we are the same species – human and live in the same planet. Hence. The ethic of care includes two moral demands: to nurture and develop those close bonds and relationship of dependency. it is essential to distinguish the three kinds of caring. Also. particularly of those who are vulnerable and dependent on our care” (pg. it is safely to say that the ethic of care goes beyond Kantian’s right. With such elements. Even though GSK and the AIDS infected people are totally stranger. and concrete well-being as seen from their own personal perspective. By such caring for someone. they become dependent and in turn to care for others. I will begin the analyzing the case using Care theory. Application: With the given analysis structure. caring after someone. particularly those dependent on us” (pg. and caring for someone” (pg. The form of caring that ethic of care adapted is to caring for someone. desires. desires.121). values.15 Caring Theory: Ethic of care is defined as “an ethic that requires caring for the concrete well-being of those particular persons with whom we have valuable close relationships.121). and by responding positively to these needs. values. you empower them to develop and capable of making their own choices and living their own life. in which treating people not just a mean but also an end themselves.121). Those are “caring about something. 122). and concrete well-being. For the second moral demand: “We each should exercise special care for those to whom we are concretely related by attending to their particular needs. The first moral demand is known as: “We each exist of relationships and should preserve and nurture those concrete and valuable relationships we have with specific persons” (pg. For the first moral ID: 1610851 . GSK violated the theory of care.122). they would lower the AIDS antiretrovirals drugs to meet the demand of the unwealthy countries. GSK also failed to fulfill the most vital form of caring. Since GSK did not perform a nurture of the infected people in developing-countries. Swaziland a country in sub-Sahara areas announced that 38. value and concrete well-being. is GSK responding positively to the needs. which is caring for someone. By not giving discount or insufficient discount amount for the antiretrovirals drugs price to the developing countries. If GSK really care about the living condition of these patients. desires. With evidence is that in 2004. The second moral demand of ethic of care is yet noticeable. instead they care about their intellectual property rights. Hence.16 demands of care theory. 4). Furthermore. “those who are vulnerable and dependent” on GSK’s care are the AIDS infected people from sub-Saharan countries. Therefore. particularly of those who are vulnerable and dependent on their care? And here. ID: 1610851 . it is visible that GSK failed to response to their needs.6% of the adult population was now infected with AIDS (article pg. Such caring for objects or ideas is not the kind of caring demanded by an ethics of care (pg. GSK did not preserves and nurture the patients from sub-Sahara areas. but at the character they are required to have (pg. where that disposition is desirable for a human being to live.131). 135). it means an ethic of virtue is a parallel scoop to look at an issue. Different from other moral principle. looking not at the actions people are require to perform. They are generally undesirable because they are destructive to human relationship (pg. Meanwhile. care). An ethic of virtue. First. we need to understand what is the Virtue Theory is about: “Virtue Theory is the theory that the aim of the moral life is to develop those general dispositions called moral virtues. deceptiveness. Hence. and unfairness are classified as vices. In another words. In additional.133). selfish ness. it makes an ethic of virtue not listed as the same categorical as the other moral principle. Pincoffs distinguishes between a moral virtue and a moral vice. In consideration of whether the agent have a morally virtuous character or not.132). an ethic of virtue judges the actions base on the disposition. It is based on the consistent of “generally desirable disposition”. cruelty. the action is treated as the primary not the disposition. besides the moral principles (utilitarianism. Application: The major agent in this case is GSK. “moral virtues are dispositions that are generally desirable because they are required by the human situations with which all people everywhere must cope” (pg. whereas for an ethic of principle. right. and to exercise and exhibit them in the many situations that human life sets before us” (pg. justice. we will need to find if their disposition lead them to perform in ID: 1610851 .17 Virtue Theory: It is assumed that Pincoffs’ statement about the virtue theory is the most applicable and relevant to the case. According to Pincoffs. 1 cents per dollar of revenue” (article. Throughout the case. Likewise. “The ten big drug companies made 17 cent for every dollar of revenue. it was not as low as the India drugs companies. According to a study.18 a way that improve and enhance the human life as well as relationship around them. During that time. a return on equity of 122 percent. pg. Even though. Since the act of the India companies were backed up by the India laws and the drugs were produce before 2006. it also reported that “GlaxoSmithKline itself had a 2003 profit margin of 21 percent. Furthermore. again it presses that GSK could lower their drugs price back then. GSK had given reasons why they could not discount the medicine cost for developing countries. But the issue here is. GSK decided to deep discount the drugs price. thousand doctors who contributed their service in these poor countries and critics strongly disagree with GSK. for some certain developing countries. Hence. GSK cannot sue them. in order to compete and take back the market. the agreement won’t be activated until 2006. GSK and other major drug companies pushed the WTO to establish the TRIP agreement. GSK’s action is ID: 1610851 . First is they did not lower the AIDS antiretrovirals drugs for the poor countries. I notice that there are two major actions GSK took. and a return on assets of 26 percent” (article. 3). compares to GSK. pg.3). many Indian drugs companies had successfully copied and produce the AIDS antiretroviral drugs with much lower price. critics argued that GSK was more than capable of lower the drugs price. while the median earnings for other Fortune 500 companies was 3. as discussed above. without concern about the small number of these drugs will smuggle back. Given that the sub-Saharan areas where AIDS epidemic is at its worst. where it’ll protect GSK AIDS antiretrovirals drugs’ patent. However. However. Second is when they have to lower the price of the drugs due to the price competition with the Indian drugs companies. However. With these given number. millions lives could be saved if GSK had such a disposition. GSK action is considered as unethical. It does not very seem like GSK disposition is to help the patients from developing countries. especially when these patients is on the edge of live and death. In consonance with the virtue theory. GSK is not found to have the character of morally virtuous.19 a clearly example of unfairness of the disposition. ID: 1610851 . Hence. a company need to make profit. in order to maintain in the business industry. regardless people who in needs. That is just wrong. it is unjust and unfair for GSK to treat the patients from the developing countries in such way. I agree that in business. What I really like about this theory is we have to develop a maxim first then apply it to everyone and yourself in a reversible situation. they just want to have as much money as they could. it sounds like we only serve customer who have money. Furthermore. The huge profit that GSK have from selling the drugs sees to outweigh the rights for the patients in sub-Saharan. However. which are the universalizability. but overall. it was not persuasive and convinces the critics. many children would have their parents back if GSK did not choose to act this way. the reversibility. Many lives could be saved. Throughout the analyzing process for this ethical issue. However. GSK clearly violated the first formulation. when GSK gave out the reasons that they couldn’t lower the drugs price. with GSK their profit’s goal not only to aim for continuing their business. In other words. in Kantian right it was developed in a deeper level. but they chose not to. Because in reality. It seems that GSK favors the rich countries and leaves out the less fortune nations. I do not agree with GSK philosophy. their life was not as appreciate as the others. these patients are still the same specie –human being with the patients in the rich countries. Even though. the theory did a good job in pointing out the unethical act of GSK. In addition.20 Judgment & Conclusion: In my opinion. Therefore. they could help the infected people. These elements of Right theory are quite similar to the veil of ignorance in Rawls’ theory. I think Right theory is the most useful one. GSK was fully capable of lower the price or giving the AIDS antiretrovirals drugs away. in which they only support countries that have money and afford to buy the antiretrovirals drugs. Even though it is quite tricky to develop the reversibility part. They also breach the second ID: 1610851 . In summations. ID: 1610851 .21 formulation where they treat the patients of developing countries as a mean for their profit. GSK committed to the unjust act and violated the patients’ rights.