These two approaches are the most applicable to the situation prevailing in the healthcare industry, as revealed by the author.
The first ethical issue that is obvious in the article is the practice by pharmaceutical firms to entice doctors, with lavish fees and expense, into promoting their own drug as against the other drugs present for the same medical condition. This is achieved through the screen of "medical education." However, this education provided by paid doctors is entirely one sided and favors one company's drug, in comparison with other drugs used for the same medical condition. This practice may lead to the promotion and use of harmful drugs, as has happened several times in the past. The companies get the credibility of the doctors, who they pay for promotion, to promote even under-researched drugs which are known to cause harm to the users.
Another ethical concern is that concerning the doctors, who agree to become drug representatives by forgetting the moral responsibility that comes with the medical profession, and suppressing their critical faculties in exchange for monetary compensation. The author was himself one of the doctors who became a drug representative for a particular drug - at first with a clear conscience and in the belief that he is helping to educate other doctors in the benefits of the drug in question, then with a guilty conscience, in withholding some negative information that he came across about the drug he promoted. The author says that the monetary and other benefits provided by the pharmaceutical firms are so large that it clouds the critical faculties of the doctors involved and makes them commit immoral behavior.
Another concern brought forth is the unethical marketing strategy used by the pharmaceutical firms in order to make the most profits, even from under-researched or harmful drugs, before the harmful effects of the drugs become full public knowledge leading to a ban on such drugs. The profit motive leads them to commit further unethical acts by recruiting doctors to promote unscrupulous drugs by attracting them with large amounts of money and other benefits. They involve other institutions in this unethical behavior, such as the pharmacies, the American Medical Association, medical research firms and others.
There are two basic approaches applicable in this situation. These approaches are used in analyzing the above concerns as below.
The Utilitarian theory of ethics is also a consequential or teleological theory. It believes in the "happiness principle" of ethics. "Utility" or "Greatest Happiness Principle" is the foundation of morality according to this theory. Actions are right in proportion to the happiness they promote and wrong in proportion to the pain they produce. So, any action that "promotes the greatest good to the greatest number" is morally and ethically correct according to this theory. There are two types of utilitarianism: Act utilitarianism and Rule utilitarianism.
Act utilitarianism postulates that any action that promotes pleasure and an action that leads to the greatest pleasure or good to the greatest number of people, even if produces pain in a few, is basically morally correct. In this sense, the action of the author and other doctors, and the firms which are employing this particular marketing strategy for untested drugs are actually promoting the greatest good