Healthy Skepticism Library item: 2216

Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.

Publication type: news

Pinker S.
Medicine's intellectual property rights attacked in Osler lecture
eCMAJ 2001 Nov 19
www.cmaj.ca/cgi/content/full/166/2/230

Full text:

John Ralston Saul, who was introduced as “a gadfly and midwife of truth” when he gave the 25th anniversary Osler Lecture at McGill University recently, says firm ethical parameters, and not ever-changing management models and new technology, should determine the health care choices Canada makes.
“Ethics is practical, down-to-earth stuff that should be normalized and used as a tool instead of being marginalized and applied only to heroic situations,” said Saul, who used self-deprecating cracks to entertain a standing-room-only crowd of 650 physicians and university students.

Saul, one of the country’s best-known writers, said many facets of our medical system are predicated on “a war against death,” but he labelled this a losing proposition. “Everyone in this room will be dead in 50 years,” he said, looking around at the primarily undergraduate audience and then revising his statement to predict that everyone with tenure would be dead within 50 years. Instead of imagining a doctor’s impact within one life span, with self-interest as its motivating principle, Saul repeatedly referred to Osler’s objective that “to teach and to think” was the highest ideal, especially for physicians associated with a university.

He also warned that a society that produces doctors who face heavy debt loads is creating “a new indentured class” that will be drawn to a 2-tiered system instead of being engaged in new pursuits that would benefit public health.

Saul also attacked the legitimacy of intellectual property rights in relation to medicine. He said the notion that any idea that “can walk with a penny attached to it” can be owned or purchased is morally hollow when AIDS patients are unable to afford the medicine that might save them.

“The reality is that a system that allows companies to own ideas absolutely penalizes health care and slows down progress. Why would you develop new treatments if you can make money from the old ones, which you own? Right now, there’s no relationship between how many drugs are available and the number of people who are sick.”

Saul concluded by calling intellectual property a feudal concept that evolved from the absolute ownership of land to the ownership of machines in the industrial era to the ownership of ideas in the 21st century. A spokesperson for the association representing Canada’s research-based pharmaceutical companies, defended drug patents as a way of recouping the approximately $800 million required to get a new drug to market. Research on new drugs accounts for 42% of all research and development done in Canada, added spokesperson Elisabeth Rode.

Saul did not propose any concrete alternatives to the moral quandaries he raised – he said he was simply setting the stage for a more morally focused debate about health care.