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feature: moral dilemmas
November 9th, 2010

Moral Dilemma #3: The Drummer and the Drug Rep

 
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After outlining the original dilemma and then adding a later twist to it, now we’re ready to hear an analysis of the dilemma from our in-house expert in moral theology and ethics.

Need to get up to speed? Read the original dilemma and then read the wrinkle and vote and comment on one or both before you read the expert analysis.

Our Expert Weighs In

Bravo to the online responders! An overwhelming majority of you in both phases said that Kara is not a physician and therefore is neither competent to diagnose her friend’s mental state nor to prescribe the right course of treatment, whether medication, therapy, or some combination of the two.

While there were many insightful and helpful comments, four of them seem to sum it up very well:

  • “Offer encouragement to see a doctor and offer to give him some names. Further, since people with depression find it hard to take the first step, ask Robert if she can help him make the contact with a doctor or offer to go along for the first visit.”
  • “It is very dangerous to give prescriptions to a person for whom they are not prescribed. If Robert is suffering from bipolar disorder, for example, giving him a general anti-depressant could be disastrous. Moreover, a pill does not automatically ‘fix’ depression, which is why it is generally counseling or other therapies.”
  • “She can reach out to him to console him, but she should also offer him names of resources (verifiable, and ethical) that may be able to help. She should not give him medication, or cross boundaries.If she has any personal relationships with a doctor, she might ask for advice or counsel, but she should not take the matter into her own hands. And she should not take it upon herself alone. And above all, she should absolutely pray for him…”
  • “I would do both the second and third in the list of [options -- 'Go be with him to make sure he doesn't try to hurt himself' and 'Offer to drive him to a nearby emergency room and try to get him some help']. And as much as my heart might wrench for him, I feel I have to be honest and trustworthy to my company as well as to him.”

Many of you who took the surveys said much the same thing. Congrats! Distributing powerful mood-altering drugs without a prescription is no small matter. For a drug company rep to even consider doing so raises red flags for me. What kind of training did she receive about the ethical, legal, and company policy ramifications of crossing such boundaries? How mature and responsible in her job would she be if, at the first request, she contemplates opening the trunk of her car as a free drive-by pharmacy?

Two deeper concerns

  • Academically, financially, personally and professionally, Kara’s attraction to Robert seems curious to me, somehow out of sync with where she is in her life and career. I’m not meaning to be a snob here, but I am wondering how someone with her talent, gifts, college degree and responsible position with a major pharmaceutical company could be so drawn to a lonely, depressed latte-maker. And then, as he pours his heart out on the phone and asks for free drugs from her samples in the trunk, why doesn’t her common-sense alarm bell go off immediately? I have some concerns about Kara’s own maturity and loneliness.
  • Several of you who wrote in have dealt with depression and/or a drug issue yourselves and noted that seeing medications — prescription or otherwise — as the answer is way too simplistic! Many “who have been there” attest to this fact. Carefully prescribed and monitored meds may be part of the solution, but almost never alone. Good counseling and supportive relationships are essential components to mental health. Thanks to those of you who took the time to hammer this point home so personally:

    “I’m not a drummer, but otherwise I’ve been where Robert is. He might or might not benefit from pills, but what he really desperately and urgently needs … what he’ll die from the lack of, if not remedied soon, is friends who care enough not to fob him off on a third party or a pill bottle.”

Lots of options

As so many who commented suggest, Kara has a variety of options to help Robert before she should contemplate under-the-table drug gifts. Emergency rooms are duty bound to accept Robert if he presents himself at their door. Also, Kara seems to have sufficient connections in the medical field to find him a sympathetic physician, who would likely meet with Robert gratis. Or Kara could foot the bill herself for an initial visit or two for her friend. There are also agencies (Catholic Charities, SSI, Medicare, free clinics) that could be tapped either for free medical services or to assist with Robert’s healthcare costs. Robert himself — with Kara as his advocate — surely has lots of options short of Kara opening her trunk for complimentary drugs.

However, one respondent did raise a genuine concern about the “facts of life” in the pharmaceutical samples business. Is it possible that physicians and pharmaceutical reps have far “too loose” access to a variety of expensive and critical medicines? While I appreciate a physician offering a free short-term supply of a medication, either to test a patient’s reaction prior to a full prescription or to tide them over until a full prescription arrives, it is a questionable medical and moral practice for physicians (and pharmaceutical reps) to be supplying patients’ full drug needs from their samples closet. If a patient needs financial assistance securing regular prescriptions, there are legitimate channels rather than using “free” under-the-table samples.

Questionable promise

With regard to the wrinkle, if Kara has promised Robert something illegal, unethical and against company policy, she is in no way obligated to deliver on it. It seems to me that the fact that she is being offered a promotion has nothing to do with it. If she now has second thoughts about her promise to share drugs with Robert, she should say so — to herself and to Robert — “on its own merit,” not because of her potential financial gain.

Also, if it is clear in her potential job promotion that she would be duty bound to police such infractions by others, then it ought to be patently clear that she has no business trafficking in such out-of-her-trunk giveaways in the first place. If her employer knew what she was contemplating, they would surely think twice about whether she is the right professional for such a promotion.

I genuinely empathize with Robert in his depression, his life experience, and his need for help. I can honestly say, “I’ve been there myself.” However, with Kara’s even contemplating being his unlicensed M.D. or free pharmacy, my concern is more with her state of mind and maturity than his need for help.

To all those who saw the problem and “red flag” immediately, you can work for my pharmaceutical company anytime. And if you then want to help some new-found friend who is depressed or in need, let’s put our heads together to do so legally, ethically and aboveboard.

Until our next dilemma… have a great Thanksgiving, Advent, & Christmas season!

Need to get up to speed? Read the original dilemma and then read the wrinkle.

Pages: 1 2 3

 
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The Author : Bill McGarvey
Bill McGarvey is co-author of Busted Halo’s Freshman Survival Guide. Bill was editor-in-chief of Busted Halo for six year. In addition to having written extensively on the topics of culture and faith for NPR, Commonweal, America, The Tablet (in London), Factual (Spain), Time Out New York, and Book magazine, McGarvey is a singer/songwriter whose music has been critically acclaimed by the New York Times, Washington Post, the Chicago Tribune, Billboard and Performing Songwriter. You can follow him at his website billmcgarvey.com or on Facebook.com/billmcgarvey
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Please note that the editorial staff reserves the right to not post comments it deems to be inappropriate and/or malicious in nature, as well as edit comments for length, clarity and fairness.
  • http://www.apple.com/iPhone/specs.HTML RockyMissouri

    She should never have divulged that she carries pills of any sort. She should be a friend and take him to an emergency room…find a list of support groups who meet and share their progress and advice – all through proper auspices- be quite careful NOT to substitute religion for an opiate… instead, opt for healthier avenues: information- information- information is key to a healthy psyche.

  • Wayne Cox

    Let me say first. That I am not telling anyone to not seek professional help. However I suffered greatly from depression. Was put on antidepressants. Spent time in a mental health ward. This may well have stopped me from commiting suicide. But little else in actually curing me.
    After losing my job and insurance. I went to work for my sister. I was just existing. Not much ambition or interest in life. While flipping through channels I would come across Christian channels and stop and listen for awhile. I did not really care for much of what they said. I won’t go into details it’s not important. What I did do is get a Bible and started to read, to see if I saw what I heard these TV preachers saying. I didn’t read much of the old testament and skipped to the new testament. After reading the Gospels I told my sister that there was alot in the Gospels that did not jive with what I heard Christians saying. What I did learn has turned my life around. First of all I try to live every moment of life by the Two Greatest Commandments. LOVE! Unconditional univerisal LOVE! LOVE as I did as a child. I no longer worry about others love for me. Thats not what I,ve been commanded to do. I work hard at not judging others. It helps me not to judge others when I remember what I did and went through to get to the point where Jesus could teach me. So when I see someone who I know is harming themselves, and others, through their behavior I know at some point they may sink low enough to be teachable. I can’t describe the freedom this has given me. I live in the moment not worrying about the past or future. Only trying to do Gods will at this moment. LOVE is magical the more you give it away the more you get. LOVE is what has curred my depression. The more I LOVE the better I feel. Even if you’re not depressed, try it, the magic is there for everyone of us. Forgive me for not answering the question. I believe that only we can decide if we are going to be happy or not. I do believe that everyone is effected when spending time with a truly loving person. May more of us become so, we can cure the world with LOVE!

  • Meg

    Robert needs people in his life that care about him, but if he feels like he might hurt himself he needs to be in the care of medical professionals who can give him te best help he can get. While she might want to try and take care of him herself, she can’t know if it’s simply a temorary condition that will easy with time and maybe therapy, or if its clinical depression, in which case medication would help him cope. In the end, meds aren’t the answer, he needs help, love, support, and God. Therefore, she should go with #3. If he fears injuring himself, offer to take him to get hepol to prevent it; it shows she truly cares about him and his wellbeing. Then be there for him as a friend and pray for him. But she should NEVER try to take the situation into her own hands, instead offer to help him find pepople who are trained to hepl in situations like this. And most of all, never give up on him.

  • Matt

    If he’s going to be taking drugs, he needs a doctor to supervise that, not a marketing department rep. She might want to give him the number of one of the doctors that she personally knows for an absolute fact to have free samples of her company’s drug, but her primary role in his life is that of a friend.

    Go with answer #2. Be his friend. Help him stay connected to the human race. If he has that, it might turn out he doesn’t even need the drugs. As long as he lacks it, the drugs will (at best) mask the real problem.

    I’m not a drummer, but otherwise I’ve been where Robert is. He might or might not benefit from pills, but what he really desperately and urgently needs…what he’ll die from the lack of, if not remedied soon, is friends who care enough not to fob him off on a third party or a pill bottle.

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