Much has been written about the unethical marketing practices of pharmaceutical companies and the role of psychiatrists and government regulators in marketing psychiatric drugs. Court judgments, research studies and whistleblower accounts have left us in no doubt that dishonesty, fraud, corruption and callous disregard for human suffering underpin the promotion and distribution of these drugs.
In this, however the pharmaceutical industry is not unique. Many potentially harmful products are promoted unethically, improperly regulated and pushed by those in related industries who receive kickbacks for doing so. Gambling, for example causes a range of harms including child abuse, loss of relationships and suicide but is marketed as fun and entertaining (with any harm arising from individual pathology – gambling addiction, poor impulse control – rather than the product), promoted by the tourism industry who receive payment for delivering up customers and is inadequately regulated by government.
What distinguishes the pharmaceutical industry is the fact that, in an outstanding and unique gift to its marketers, governments have passed legislation allowing detention of potential customers and forced administration of its product to consumers who do not wish to purchase it.
Tourists who arrive in New Zealand have a range of options to satisfy their needs for entertainment: bungee jumping, whitewater rafting, snorkeling, sightseeing, shopping, nightclubbing, theatre, and of course gambling at our casinos. The providers of these entertainments compete with each other on their ability to satisfy their customers’ needs on price and on safety. The quality of their product and their customer care determine the market share and profits they receive.
Now imagine if tourists on arrival in New Zealand could be detained by tour guides, forcibly taken to the casino and made to sit in front of a pokie machine or roulette wheel for days or weeks until all their money was gone, their travel companions had left in disgust and their children, unsupervised at the airport, were taken into care. What a windfall for the gambling industry!
Imagine if the government passed legislation allowing for the detention of car buyers and the issuing of court orders that mandated them purchasing and driving a small range of government-approved vehicles because the government decided these vehicles were safe and it was in the best interests of citizens who have been involved in non-fatal crashes (and are therefore a risk to themselves and others) to drive them.
What a furore would ensure from competitors and from the public, from the business community and free market champions.
Isn’t this exactly the situation that exists for pharmaceutical companies? Government has passed legislation that allows those who do not want to purchase their drugs to be detained and injected with their products against their will, while the alternatives to pharmaceuticals are never forcibly administered. No one is forced to attend art therapy, counseling or acupuncture. Children are not forced to undergo play therapy in order to access education despite clinical studies showing these interventions to be more effective than antidepressants or stimulants.
Marketers know that there are certain segments of the population who will never purchase their products. They know that publicity about harm arising from use of their product will seriously affect demand. They leave alone those segments of the market to whom they offer no interest and withdraw defective products or invest in improving their safety profile. They operate in environments where consumers exert control over the market penetration and profitability of their product and where companies who ignore customer perspectives and needs do not survive.
Any marketing executive would kill for legislation mandating use of their product by customers who resist their marketing efforts, legislation that removes consumer control and the impact of market forces. It not only provides a (literally!) captive market but endorsement of their product by the highest powers in the land, across the entire market.
Given governments and the public are so indoctrinated with the view that psychiatry is the cure for mental illness and that pharmacological treatment is safe and effective, I’m wondering if rather than trying to change their views and repeal compulsory treatment laws, we should propose compulsory gambling or vehicle purchasing to our local representatives and when they patiently explain to us that this is not possible in a free market economy, ask innocently why psychiatric drugs are different than other drugs and any other product.