It doesn't take a knee-jerk Rightist to dispute your assertion that it's cheap to develop modern pharmaceuticals. Malarkey--the R&D tabs routinely run in the hundreds of millions. It's analogous to physics. A century ago physicists could make significant advances using equipment built from common household items; now it takes multi-billion dollar superconducting supercolliders. The low-hanging fruit has already been picked.

The thought of US pilots cranked up on speed bothers me, maybe because it's reminiscent of many sci-fi/combat stories about future soldiers pickled in drugs to suppress their consciences and heighten their reflexes. But it's war...I'm conflicted about that one.

What's basically bothering you, I think, is the conflict between property rights (intellectual property, in this case) and human rights, and that's a deep one. It's vivid in the case of pharmaceuticals, but shows up in other areas like the relationship between private real estate ownership, which leads to cost inflation due to scarcity in most areas, and homelessness.

I'd note that doctors take an oath that obligates them to help alleviate human suffering if they can, regardless of whether or not they're paid; that is, their "property rights" to their knowledge and skills are circumscribed by considerations of morality.

Drug companies don't take a Hippocratic Oath, and clearly don't feel any moral obligation at all. Yet, over the last century, the focus of medicine has shifted from the knowledge and skills of individual doctors, to the knowledge and skills embodied in pharmaceuticals and the production thereof. Nowadays pharmaceutical companies also practice medicine--pills are a way of mass-producing medical treatment.

Should drug companies be bound by something like the Hippocratic Oath?

Yeah, I think so. Money is not the highest human value, at least to me. If exercizing property rights contributes to human misery, it's the property rights that should be compromised...else we're no more than greedy barbarians and can't claim to have achieved civilization.

I'll bet Tom already has some boilerplate on the clipboard ready to paste into his response, some variation on "Socialized medicine--ewww!", or "The profit motive is responsible for innovation--so there!". Down boy...I'm saying that special circumstances obligate us to think about a compromise between dire human need and reimbursing drug companies for the cost of development. To return to my analogy between drug companies and doctors, doctors long ago figured out how to collect enough money from patients who can pay, to support the doctor and his clinic, while covering the costs of treating indigent patients. Heck, even lawyers acknowledge a responsibility to perform pro-bono work. If even lawyers can do it, so can pharmaceutical companies.

--Robert