Hopkins 1 Paul Hopkins Professor Heppard Current Moral & Social Issues May 9, 2012 The Unethical Marketing of Antidepressants as a Medical Cure for Depression There are numerous ethical issues in modern day America, and a major one that is not yet much talked about is that of the use and distribution of antidepressants. The rate at which these “medicines” are being described is, needless to say, atrocious, disheartening and, no irony intended, sad. This epidemic needs to stop, and I am not talking about the “illness” named depression, but rather the real illness of doctors and other prescribers who dole pills out like candy. There are countless problems with the very idea of mental illness, first and foremost is if such a thing even exists, at least on any sort of physical level. In other words, the “experts” have yet to prove there is any sort of physical abnormality that causes illness therefore making the entire mental illness field questionable at best. To make matters worse, drug companies spend millions to billions annually on their notorious marketing strategies and campaigns. This includes both advertisement directed to professionals and directly to consumers themselves. This means that medical advice is essentially being given over television sets to laypersons with little to no background in such a field, yet are sought after as if they can legitimately self-diagnose. Likewise, regular people come enter doctor’s offices convinced they are depressed before uttering a word to the supposed professional. To further complicate the issue, increasingly more general practitioners willingly prescribe heavy duty “medications” for an extended or even indefinite period of time with only a ten to fifteen minute consultation with the patient. This sort of practice is inexcusably wrong on two fronts: one being the entire field of psychiatry is illegitimate, and secondly even if the field holds some truth, generally speaking regular doctors have little background or experience in treating the incredibly complex psychiatric issues. I personally would argue that psychiatry is some sort of twisted joke, as there is no solidified proof at all that depression is a medical Hopkins 2 illness. This is not to mention that the experts are not even sure how the very drugs that they prescribe work. The entire field is based solely on theory which means there is no scientific proof like that which backs other legitimate illnesses. Let us consider a simple definition of ethics for a moment, then relate it to the issue at hand. Ethics simply equates to moral philosophy which means determining right versus wrong and good versus bad. The entire idea of psychiatry is bad, but more specifically the marketing of antidepressants is wrong, especially when directly targeting potential consumers. Medicine in general should not be marketed, or advertised, especially to the general public who has little to know medical knowledge. Furthermore, the advertising towards doctors and other professionals is not morally permissible either. Medicine ought not to be marketed. Healthcare should not be for sale. Clearly capitalism has invaded all sectors of society when such things are turned into “for-profit” businesses and corporations. Taking care of fellow human beings should not be a “for profit” business; it should just be a natural process. This would rid of a whole host of problems. Let me first establish the problem with the diagnosis of depression itself. Most notably, depression has yet to be proven as a physical disease or thereby any sort of legitimate illness at all, whatsoever. So this essentially means the “science” of psychiatry is based on sole theory; a myth. In fact, all the attempts of proving depression to be an illness have only further made strides at proving the very opposite. In other words, this disease is manufacture, conjured, made up. This is not to say what really is depression is a fallacy, but rather how the idea is commonly understood is just plain wrong. There are definitely people that suffer from depression, but that brings me to the question of what is depression exactly? Between my extended amount of research and longtime personal experience I have come to realize a few things about what society calls depression. Frist of all, depression is a dis-ease, not a disease. What do I mean by this? Well, depression can be put many ways, but one aspect is that Hopkins 3 life simply does not flow smoothly anymore. Your life is disrupted. Your progress is stalled. You do not feel well, even sick sometimes for no apparent reason. There is always the obvious one of consistent, abnormal feelings of sadness, despair, hopelessness and even suicide. Perhaps breaking the word depression down would be helpful. Even upon first glance at the word, one ought to notice the structure by which the root press shoots out, then depress becomes clear and soon one can quite easily come to the conclusion that this thing is not good – for to depress something is, put basically, to bring something down. Now, depression is the form in which the dis-ease takes place in a negative way. On the same note, one may think of it as quite simply bringing down one’s spirit. There is a weight taking a toll, putting pressure on the soul. There are many ways of basically saying the same thing. So then, what differentiates “normal” sadness from “abnormal” sadness? This is an excellent question. There is no perfect, universal definition for normal versus abnormal sadness for the root norm instantly means whatever it is referring to is relative, and thus varies person to person. That being said, there are some qualifications that may be discussed to suggest when sadness may cross the line from normal to abnormal. However, I do not like the word normal, nor abnormal, at all really, so I will from now on use the words health and unhealthy to differentiate between the two modes of sadness. A good, solid, relevant example is that of grief. When a loved one dies, one should feel sad. This is healthy, and to be expected. In fact, if over an extended period of time one does not feel some form of sadness, this may be unhealthy, but we can save that for another discussion. However, only when one feels consistently sad over an extended period of time, for no apparent reason, does it become an unhealthy problem. Actually, I am not sure that this is even completely true when considered in relation to general health, but in terms of mental “health” I think it is perfectly usable. Mental “health” is, in actuality, mental wellbeing for deeming it health would allude to mental unhealthiness as an illness which, as stated, it clearly is not. Hopkins 4 According to ethical egoism, the treatment for depression by which is marketed is horribly wrong. The very definition of this theory is such that individuals the best judges when it ones to figuring out what is best for their own interests. The act of marketing antidepressants severely violates this theory. Instead of allowing the consumer to decide what is best, what is best of their own good, commercials and other advertisements essentially decide for them. The marketing is more like propaganda. There are messages conveyed to the brains of viewers that they themselves may not even be totally aware of, and in all likelihood probably are not. The major problem is that the treatment of depression is advertised as a “one size fits all” solution. The advertisements make gross generalizations that could sensibly be applicable to all human beings. The big one is that everyone gets sad, sometimes for longer than one or two weeks on most days, especially when going through a trying life event or period of time. This is “normal” and definitely not any sort of illness. However, if one is to listen to the common television commercial for any of the wide variety of antidepressants being marketed in the United States, it will always go something like this: “Do you feel sad? Do you wish your sadness would go away? Do you want a pill that will take your emotional and mental pain away? Consult your doctor about starting out on a dose of X.” Well of course nobody really enjoys feeling down or sad, especially during the heat of the moment, but people need to realize these are essential, natural aspects of life. They are literally hallmarks of humanity. Without sadness there would be no happiness, without pain there would be no pleasure, et cetera. More or less, antidepressants are marketed with a very utilitarian mindset. There are two major problems with this. First of all, the so called “majority” of depressed people who “get the message” are internalizing false information, half-truths and downright lies. Then, secondly, lies the “minority” who receives the message but does not feel included and thus hopeless since there is only one method of treating depression that is advertised in the United States. However, considering the principle of utility, one must realize that this is therefore a teleological and consequentialist principle by nature. This Hopkins 5 means that the end or consequence is what is of main concern, not the motive of the act. With this in mind, the treatment of depression is at least somewhat successful and this is probably why biological psychiatry is still in business today. For after all, the shared goal of all psychiatrists, no matter their individual views or preferences, is to eliminate or substantially reduce many to all symptoms of the “illness,” depression. In this light, marketing and the ensuing treatment of depression is, to at least some degree, successful because frequently at least some symptoms are reduced or eliminated. However, we must consider at what cost, and from whose perspective, is the treatment successful, and then also to what degree. In my mind, the duty of the doctor is to eliminate all symptoms while maintaining, or actually improving, the patients’ state of health and well-being. This is what psychiatry should be obligated to do. Notice, there is not one mention of hurting or harming the individual, yet this is what commonly occurs. The goal is tainted at best because in essence treatment assumes something to be wrong. And when considering a medical treatment, this means something is supposedly physically wrong or ill. This is simply not the case, as far as there being a determined, proven physical cause to depression. I am not attempting to state that there are no physical manifestations or by products of the dis-ease, because there are. However, the biological basis of modern day psychiatry is simply a based on poor science and sole theory, instead of fact and truth. This alludes to another dynamic issue in the marketing of antidepressants. The big pharmaceutical corporations have done an incredible job of maintaining the myth that the cause of depression is known, thus making their products seemingly legitimate. In fact, the companies literally rely on ignorance to make profit. These companies do not want the people, or even the professionals, to know the truth – which is that the scientists, the doctors, nor the researchers or other professionals know of any medical causation of depression. Not only do companies survive, though, they actually thrive on the lack of knowledge by consumers. Hopkins 6 The advertisements are quite misleading and almost always biased. The giant misconception is that depression is an illness. Beyond that, is the supposed solution that comes in pill form and even furthermore is the encouragement to consult a doctor about obtaining and starting the advertised drug. Of course this is biased because the advertisements come directly from the manufacturers of the drugs. Of course these companies only want “good light” to be shed on their products. The government imposes some regulations that make the companies legally obligated to state most major or common, side effects. Besides that, only a small part of the story is told, and the side effects are always read off at a nearly incomprehensible rate. So the advertisement is quite unbalanced. A brief tour of the history of modern psychiatry is required to understand how the current situation came to be. Although there is a significant portion of prior history, for the sake of time, the time period post-1940’s will be discussed. At this point in time during the 1950’s “’American psychiatry accepted psychopharmacology as its domain,’” (Whitaker 264) as stated by the former National Institute for Mental Health (NIMH) director Gerald Klerman. At this moment, the theory of biological psychiatry, or biopsychiatry for short, joined forces with the pharmaceutical industry reaffirming the physical basis for the so called disease and creating a lasting, lucrative partnership that still is very much alive today. This also “legitimized” or authenticated psychiatry as a practice and profession by joining “officially” the medical community of treating biologically based illness with medication that was “proven” to “work.” Two decades later, however, the American Psychiatric Association (APA) along with psychiatry as a whole was under attack. There was a definite period of discontent and this was very much a trying time for psychiatry. The first problem was that, beginning back in 1961, Thomas Szasz authored a book entitled The Myth of Mental Illness in which “he argued that psychiatric disorders weren’t medical in kind, but rather labels applied to people who struggled with ‘problems in living’ or simply behaved in socially deviant ways,” (Whitaker 264). This ignited an anti-psychiatry movement involving professionals and academics alike, all of whom questioned the accepted biological model of psychiatry. Secondly, Hopkins 7 psychiatry was facing competition for patients as psychologist and other counselors were taking potential patients into their nonmedical care. There were also internal divisions such as the Freudians and “social psychiatrists” whom neither completely subscribed to the medical model and drug therapy, for different reasons but the same conclusion. On top of all this, medications were failing in the marketplace. Unfortunately, psychiatry made a nearly heroic comeback, beginning in the 1970’s with the effort to “remedicalize” psychiatry. The APA spearheaded the effort to do so by which the message that psychiatrists must accept and embrace the role of a real doctor was more than clearly conveyed. Whittaker appropriately titles this section of the book as “putting on the white coat.” Although satirical, the point is transmitted. Countless articles were published and talks given framing psychiatry as the medical profession utilizing psychoactive medication (and electroconvulsive therapy – ECT) as the proper treatment for the diagnosis of various mental illnesses. As Tufts University psychiatrist David Adler puts it, “’the medical model is most strongly linked in the popular mind to scientific truth,”” (Whitaker 269). Mistakenly, this means that the general public typically takes the medical model for truth. This should be just fine, however there is one enormous problem – this “medical model” is false. To make matters worse, the APA enlisted Robert Spitzer of Columbia University in 1974 to lead the project of revising the APA’s Diagnostic and Statistical Manual, which is the go-to guide for psychiatrists in the United States. Spritzer and his team invented a new manual which clearly reinforced the idea of mental illness as a medical problem, with instructions on diagnosis and “appropriate treatments.” This work quickly became and is to this day, the practicing biological psychiatrists’ bible. Evaluation of this manual came quickly and out of the mouths of many critics. Primarily, the critics were clueless as to why the work was touted to be of great scientific achievement for there was no legitimate science involved. Whitaker exposes the truth as follows. “No scientific discoveries had led Hopkins 8 to this reconfiguring of psychiatric diagnoses. The biology of mental disorders remained unknown, and the authors of DSM-III even confessed that this was so. Most of the diagnoses, they said, ‘have not yet been fully validated by data about such important correlates as clinical course, outcome, family history, and treatment response,’” (Whitaker 270). So what do they know? Apparently they do not want to admit that they do not really know of any sort of proof for depression as a medical disorder. To make matters even worse, the APA created an environment in which those who did not submit to the medical model had a rough time finding or keeping their jobs. The system in consequence quieted a lot of potential critics. Once all of this was accomplished the institution set out to market is “medical model” to the public, and did so with quite a force. The APA turned itself, and psychiatry, to a “marketing machine” and quite an effective one at that. To start things off, the APA created its own press in 1981. In addition, the organization began to court the popular press, which spread the message like wildfire with what Whitaker deems an “all-out media blitz,” which all paid big dividends (Whitaker 273). This meant direct to consumer marketing, not only occasionally in doctors’ offices, but constantly across virtually all forms of available media. Before further critique, one ought to evaluate what is being marketed – the drugs themselves. It should come without much, if any, surprise at this point, that the medications used to treat mental illness, but unipolar depression in particular, have an awful track record. Ungrounded theory leads to bad science which produces a poor product those consumers are duped into believing that they absolutely need to take if they ever want to experience joy or happiness ever again. Naturally something built upon purely fictional theory is not going to be honestly successful, and antidepressants are surely no exception. Amongst critics, antidepressants along with psychotropic medications in general, are touted as “magic bullets.” This is very telling. By the way pharmaceutical companies promote and market the drugs they produce, this name is very appropriate. The companies claim that their products can do so much for an individual, all with minimal to no harm or negative side effects Hopkins 9 worth considering. Basically, the drug companies play their products off as perfect until enough criticism is built up in regards to a certain generation then a “new” class “comes out.” So then what exactly do the drugs do? Doctor Peter R. Breggin is known as the conscience of American psychiatry and is one of a small number of medical doctors whom decided to investigate and provide answers to this murky question. Reliable, accurate, straightforward information about the medications on a whole – i.e. information on a class of antidepressants – and individually – i.e. the selective serotonin reuptake inhibitor (SSRI) called Prozac. In his 1991 book entitled Toxic Psychiatry Breggin goes into detail about the dangers of the “New Psychiatry,” or biological theory. The medical doctor is one of the top critics of psychiatric drugs and the larger psychopharmaceutical complex. Breggin was once a full-time consultant at the NIMH and has been in private psychiatry practice since 1968. In short, he is an extremely experienced, well versed medical doctor who has literally devoted his life to exposing the truths about psychiatric drugs and the psychopharmaceutical complex. He is truly an expert in the field of psychiatry. In Toxic Psychiatry Breggin explores the ills of the “New Psychiatry” based on the biological “medical model” of an “illness.” In his chapter on depression, he discusses the business of psychiatry. He writes: “Psychiatry and the pharmaceutical industry have been marketing depression as a “real disease” in need of medical treatment,” (Breggin 122). He goes on to directly refer to this marketing as “propaganda.” However, he also states that “depression is a readily understandable expression of human despair that is frequently responsive to psychosocial help,” (Breggin 122). The point he is making is that psychology, and the difference is key, is a great tool that can work wonders when practiced properly. Even more significantly, Breggin rightfully reminds the reader that depression, or sadness, is a perfectly normal and even healthy response to despair, not some sort of abnormal disease requiring medical treatment. Hopkins 10 When it comes to the actual effects of the drugs themselves, there are three phases to be mindful of – the beginning of the drug, the duration period of usage, and lastly the withdrawal. Starting a medication is typically quite easy, although also frequently leads to harm, however the initial period of starting a new medication is usually rather uneventful for the first couple of days, although not always as effects can be seen immediately. The good news at this point though is that a drug can be stopped virtually at once before the medication builds up in your system. Your body does not acclimate to a new substance completely that quickly; one does not grow dependent within one or two dosages. Everything changes though once the patient reaches a “therapeutic” dose and takes this for a period of time, usually about two to four weeks, sometimes six for the full “effect.” The two to four weeks is the standard time frame given for most all antidepressant drugs to acclimate, when what is really happening is a growth in dependence. This brings up yet another issue that is rarely talked about, but of which is the dependency and addiction factor that comes into play, especially in regard to long-term users of these medications. Before we discuss the full-fledge addiction problem, a discussion of the more immediate effects is only appropriate. Yet even before that, it must be known that first and foremost very little is actually known about the brain of where New Psychiatry’s biological medical model exclaims that chemical imbalances of certain neurotransmitters occur resulting in mental illnesses like depression. In another one of Dr. Peter Breggin’s books, the textbook titled Brain-Disabling Treatments in Psychiatry, the following lesser known statement is made in the preface. “Despite claims to the contrary, these psychiatric disorders have no proven genetic, chemical, or biological basis,” (Breggin xxiii). Breggin plainly exposes that there is simply no scientific basis for depression, or other mental illness, as a disease. The idea is simply false. This truth, though, also comes with ramifications considering the vast array of people taking psychiatric medications, many to most of whom have never been told the truth about the pills they are taking , and frequently if not always the whole truth is never known. This is Hopkins 11 essentially malpractice and countless suits, criminal and civil, have been brought against drug companies and doctors alike for this very reason. Unknown risk factors that would have prevented patients from taking the drugs are commonplace. The psychiatrist reason that the patient is in need of medical help and that this sort of assistance would not be accepted or taken if the user actually knew of the potential side effects and other risks associated with taking a psychiatric medication. To make matters worse, a large number of users end up taking these drugs for extended periods of time, even life times, before if ever discovering the truth about what they are ingesting. The results are sometimes nothing short of fatal, as drug-induced suicide is not at all an anomaly. Ironically, the real problem is created by the medications themselves. There is plenty of science to back this statement up. In actuality, all studies and science in general leads to this conclusion to one degree or another. At best the drugs are “proven” to be worthless. At worst the medications are literally proven to be deadly. There has yet to be a conclusive study showing that any antidepressant actually “works.” This is the hidden fact that most consumers do not know about, and those who do have more than likely found out through intense, diligent research which requires inordinate amounts of time and effort, just to dig up the truth. The fact is this: we do not know how the brain works, and even if there are “chemical imbalances” that occur during periods of depression that does not mean they are cause resulting in an illness. Because of all of the unknowns, the way in which antidepressants, and psychiatric drugs in general, “work” is not known either. Furthermore, there is nothing known that is factually even suggesting that these medicines are truly effective. This is not to say these drugs are simply placebos, or have no effect, for they definitely do, although it is frequently a detrimental one. “Instead of correcting biochemical imbalances, psychiatric drugs cause them, sometimes permanently,” (Breggin xxx). This begs further exploration. Hopkins 12 Breggin then begins to discuss how the drugs work. “In essence, the brain-disabling concept as a whole sates that all psychiatric treatments – drugs, electroshock, and lobotomy – work by disrupting the function of the brain and mind, creating effects that are then interpreted (or misinterpreted) as improvements,” (Breggin 1). What he means by this is that the drugs in practice “work” by either impairing or even shutting down portions or functions of the brain. There is evidence of this is in repeated laboratory studies in which rat and other animal brains are found to be moderately to severely damaged after ingesting these drugs regularly for set periods of time, ranging in length from days to a couple of weeks, to a month or more. Generally speaking, the longer the length of time, the harsher or more severe the effects. Important to note is that what are thought to be side effects are in actuality primary effects. In other words, the drugs are literally designed to damage the brain. The very drugs that are supposed to alleviate chemical imbalances, ironically, create them. A report authored by psychiatrist Richard Kapit in 1986 repeatedly warned that fluoxetine (Prozac) “had a stimulant profile similar to amphetamines. He [Kapit] was concerned that stimulant effects such as insomnia, nervousness, anorexia, and weight loss would produce agitated depression and worsen the condition of some depressed patients,” (Breggin 139). So then the consequence of taking a pill to ease your depression would, in some cases, worsen the very symptoms one was troubled with initially. On another hand, rarely if ever would a patient know that Prozac resembled amphetamines as that would surely deter countless potential users. Additionally, even the so-called side effects would unlikely reach the conscious of the consumer. Also, the medication could very well cause the patient new bothersome symptoms such as the insomnia nervousness. So why on earth would anyone agree to take such a pill? Considering contractarianism, this scenario is a major violation. By definition, this theory calls for informed agreement, and a typical psychiatrist visit is anything but. This if not of total fault of the doctor, because the psychopharmaceutical complex has infected the very school in which he received his education. So in theory, the doctor is doing a great job – he is doing what he has been taught to do, Hopkins 13 and especially taking the amount of prescriptions penned, he is doing an incredible job. However, ethically speaking, this practice earns itself a failing grade, particularly when taking contractarianism into account. The key words here are informed agreement, and even with just these two words in mind, we can break down the definition and relate it to the system of unethical marketing and distribution of these drugs exposing the fallacies in hopes of exploiting the truth. First one needs to think about the word informed, which means to be knowledgeable of or familiar with. More often than not, nearly all of the time, a patient whom seeks help from a psychiatrist is awfully under-informed. The typical strategy of the prescriber is to convey as miniscule amount possible of only the most common and, or, less severe side effects while grossly overinflating the benefits. This results in an obvious lack of information conveyed to the patient because the doctor always leaves at least something out. This is not an overstatement since relaying all of the information or even close to the information – enough for the patient to make an informed decision – would take a lot of time and explanation. Besides those factors, the patient would never agree to begin to take the medication if they in fact knew the truth. Costbenefit analysis would take mere nanoseconds because the facts essentially decide for the patient that consuming such a chemical compound is a bad idea. Second to consider is the word agreement, which means to agree or accept an offer. This other part has proven to be quite problematic, too. Assuming a patient is actually given the straight facts, and is pondering taking an antidepressant, they still have to personally agree. This means the patient, as an individual, must independently decide for themselves whether or not they will take such a medication. The patient must be given sufficient time to weigh the risks versus (if any) benefits, and reasonably come up with a response to the possibility of starting to take a psychiatric medication. A contract is “a transferring of right” according to the Ethics textbook (MacKinnon 101). In this scenario, the contract is between the patient and the doctor. The right which is being transferred is that of which permits the doctor to experiment with your body by way of ordering you to take a prescribed medication X number Hopkins 14 of times per day for a certain period of time. This gives the doctor control over your body, and even worse, your mind. For these medications are all mind altering agents, whether commonly described as such or not. These drugs will change the way you think, the way you feel, and your physical biology. That is a clean cut fact supported by a multitude of scientific evidence documented in a wide variety of medical journals and other publications. The truth is out there, it is just a shame that it is so hard to find. So why and how is it that the biological myth is what is being marketed as opposed to the truth? The answer is quite simple under the realm of capitalism in which profits drive businesses which means money is the primary motivator. Quarterly earnings have proven to be more important than human lives, at least a degree. In Michael Moore’s critically acclaimed documentary Sicko he presents a valid argument that healthcare corporations benefit from keeping people alive but sick – sick enough to “need” the medications, the tests, the doctors’ visits, the surgeries, et cetera. In reality the system is set up in such a way, as far as the big pharmaceutical companies are concerned, to drive sales of medications literally at the expense of overall human health and quality of life. This is awfully disturbing, but nonetheless true. For if people were properly informed about the dangers of antidepressants, very few, if any would willingly agree to start taking them. However marketing does an incredible job of convincing people otherwise. Between the glossy pamphlets and brochures, to the free pens and pads of paper, to the notorious internet and television advertisements, the average person is bombarded with “information” all skewed towards convincing someone they absolutely need to take a certain pill in order to achieve success or attain happiness. This is truly nothing short of malpractice and false advertising. However, due to the enormous profits and hence power of these gigantic corporations, the pharmaceutical industry has successfully been able to employ lobbyists in governmental agencies and arenas to essentially allow for this to continue. And Hopkins 15 there is no end in sight. As long as the system remains the same in structure, money will be the primary motivation which means human health – and literally lives – are secondary. One would hope human health would be the top priority in healthcare – but that is clearly no longer the case in American medicine, put specifically in psychiatry. This is sick, and morally wrong, yet has become commonplace as this has become the standard practice in psychiatry. So yes, disabling what was once normal brain function is what psychiatrists are calling success in terms of treatment of mental illnesses. The worst part is the paradigm by which researches and scientists are fully aware of the harmful effects, yet market the very same drug to the general public and professionals, including doctors, alike as medicine that is the sole cure for the disease of depression (or insert any other mental illness such as ADHD because the same concept applies). The real mental dis-ease lies in those providing and supporting the healthcare system which includes the researchers, scientists, marketers, and the doctors themselves. This all leads to a gross overmedicating of patients and even society at large, for one person taking a pill like this is too many as far as I am concerned. Granted there are some situations in which these drugs may be temporarily of assistance, but there is no reason any psychiatric drug should be prescribed for any kind of long term use, not to mention a lifetime. Harvard educated psychiatrist James Gordon agrees. The obscene marketing of antidepressants, especially in the United States, is unethical and wrong. In fact, the current medicinal practice of psychiatry, or perhaps more appropriately called business of psychiatry, can be more accurately described as malpractice. To say the system is flawed is a gross understatement, the system is morally impermissible. What gives one human being to tell another human being that their thoughts are so wrong that they need laboratory made chemicals to “correct them.” How can someone tell an individual that their entire metaphysics is wrong? What Hopkins 16 entitles them to prescribe drugs to “correct this?” I mean there are some example by which I would say are wrong such as killing someone, but even so, is a pill the right answer to such a problem? Especially one that is actually detrimental to one’s health, and comes with such risks as seizures and shortened lifetime or early death but despite all of this is deemed a cure. The enormously powerful pharmaceutical industry, with lobbyists and other governmental positions in tact, flexes their muscles a little bit, provides some monetary incentives, and then advertises their herald new product to anyone who might listen, and even to those who refuse at first. Over time, anyone whom uses the internet or television, they will be subjected to the advertisements for a “disease” that every human being encounters periodically which is called sadness. Instead of riding out a wave that will inevitably break, consumers are not so sublimely directed to consult the nearest doctor to obtain a prescription. Of course some of the side effects are read through rapidly at the end, to meet regulations by the health agency, but the target is still reached. I mean, very simply put, who wants to feel sad? So here is a desperate person who thinks to themselves they would do just about anything to “feel better” – as if they really were sick – and then such an advertisement comes on. The individual runs the pros, which greatly out way the cons, and soon discerns this method is at least worth a shot. Before long, he makes the appointment with his doctor, frequently a general practitioner, and talks with him or her for about ten to fifteen minutes and leaves the office with a script for Prozac at 20 milligrams to start that evening. This is quite a common scenario in which a diagnosis of depression is given after a quick conversation leading to the prescribing of an antidepressant that the patient will be ordered to take for a few weeks at least, with maybe one checkup. The consumer becomes the patient in a matter of minutes. The patient is soon dependent on drugs to make him “happy” or at least not so sad. He learns that these pills are the sole reason for this sort of “progress,” and if he or she decides to stop taking them they will inevitably lose all of their “progress” and fall into another bout of sadness or “depression.” For many doctors and patients alike, the pharmaceutical corporations have made regular Hopkins 17 sadness equate to depression. If fact, as it stands now, if sadness persists for more than one to two weeks, on most days, the individual meets one major criteria for suffering from a “depression.” Granted, this diagnosis is a medical one, and yet there are no examinations or tests known to man that can be used to measure any sort of potentially abnormal levels of neurotransmitter chemicals or other levels of anything physically wrong with the body to indicate a depression. So this so-called diagnosis is purely based off of what the patient reports verbally, and thereby an assumption is made that the selfreport is accurate and indicative of a physical problem within the body. Thus, this is very much a guessing game with no sound science backing what many claim to be a disease. Despite all of this, antidepressants are one of the top types of medicines prescribed annually, and the rate translates into a billion dollar industry for the pharmaceutical companies. According to the theory of utilitarianism, this precept fails because only the drug companies and healthcare providers benefit while the majority – the patients and their families – quite literally suffer. If Kant was able, he would dub this complex as morally impermissible, as the actions of the practice are wrong. Any consequentialist theory would prove the unethical ways of the psychopharmaceutical participants as bad, as the results are worsening health and wellbeing experienced by the patients. Even the true motives for the practice, which comes down to desire for profits, are wrong. Any way one looks at this practice, the grade is still a failing one. There is just no good way to spin the psychopharmaceutical complex – unless of course the person in question is a doctor or drug industry representative, or the like.