Effects of Pharmaceutical Treatments On Structural Circumstance - Research Paper Example

Effects of Pharmaceutical Treatments On Structural Circumstance Medical research has seen extensive development over the past years. New treatment procedures, more effective drugs, advances in bioengineering and researching techniques have changed the conventional concept of therapy. Jurisdictional laws have been mould to accommodate the plethora of ethical issues that have emerged parallel to these changes. Earlier medical professionals used to study the human body from dissections and the works of previous anatomists. However, the focus of study has shifted from the macro to the micro level. With sophisticated microscopes and specimen preservation techniques, cellular life can be studied in great detail. Due to technology the normal workings of the vital processes of the body like aging do not seem very inescapable (Rose, 2007). Researchers have started manipulating genes and tailoring them according to choice. Although a break-through in medical research, such issues have raised debates regarding the ethical and moral aspects of biotechnology. Today, bio-politics and bio-power are the central issue in the world of medical science. This paper aims, in light of anthropology, to discuss the extent to which bio-politics and bio-power can affect the pharmaceutical treatments that are provided by health professionals. It analyses in detail if the focus on pharmaceutical treatments detracts attention and resources from the structural situation. Ethical implications of pharmaceutical treatments are considered to be part of the treatment. Therefore, the paper discusses the ethical issues of these treatments and assesses if stress on these issues draws attention away from the key objective. AIDS still continues to be an epidemic to the modern world today. To understand its cause and its impact is manifest (Harris & Siplon, 2007). Today more than 11 million people are affected by AIDS while several millions are carriers. The HIV virus poses a threat to the world today because no effective vaccine has been made against it. The scope for pharmaceutical treatments is hence magnified. The market for new drugs and therapies with potential promises for curing a fatal disease is large. It is not just the poorer population which is at risk. AIDS can spread through blood transfusions, unsafe sexual practices and intravenous drug users. The pressure of an effective vaccine and the market share such a vaccine can have is an incentive for many pharmaceutical companies to research and invest upon. Antiretroviral therapy is a field of research that holds promises for breakthroughs in medical science. Researching a cure for AIDS by developing antiretroviral drugs that inhibit the virus form proliferating and halt the progressive onset of the disease. HIV infected people are also eager to enter clinical trails in order to ameliorate their condition (Kuhser & Singer, 2009). The debate that surges with such advances and development in the field of immunology and virology is not only centered around the feasibility of such research but also on the biopolitics that ensues. Antiretroviral (ARV) therapy requires an extensive amount of research. It is not possible for developing countries to fund such research projects on a large scale, since studying the reproductive cycles of the virus would require high-tech equipment. Moreover, experimenting on effective treatments would also require resources that developing countries can not afford, like a team of expert virologists, conducting trials on subjects etc. Therefore the monopoly of developing ARV drugs automatically goes into the hands of developed countries (Carvalho 2010). The market share of developed countries is also high in terms of receiving the treatment (Serra & Stiglitz, 2008). The consequences of such a monopoly influence the delivery of new drugs to developing countries. Pharmaceutical companies can set process of their own and dictate the terms of delivery of the drugs. They can exploit the poorer countries by using their labor and conducting trials on them, while selling the drugs to developed countries at higher prices. The aid and drugs granted to poorer countries comes with strings attached (Yahoo!7, 2010). Poorer countries, as a result, do not get benefited extensively by such advances in ARV therapy. In 1999, the US actually threatened South Africa with trade sanctions for trying to fight AIDS (Shah, 2002). Therefore, one can see the shift in the objective. ARV drugs, which were initially meant to fight off infections and prolong the lives of the patients, have limited availability in poorer countries. Pharmaceutical countries are attracted to the Third-world as trial sites (Balint, Baker, Strosberg, & Philpott, 2006). The motto of philanthropist organizations like United Nations falls short of the outcomes. Consequentially, the goal of provision of effective treatments for the HIV for all is not met. The disease can not be eradicated if some countries continue to be plunged into deeper crisis concerning the HIV spread, with the number of AIDS patients on the rise. Countries in South are also deprived of using the available treatments because of international property laws that favor transnational pharmaceutical companies (Payne & Askeland, 2008). One can conclude that due to the focus on pharmaceutical treatments, the main objective of countering the spread of HIV virus is lost. Only a selected few countries are benefited, while others still remain to be introduced to new drugs by pharmaceuticals. In accordance with Biehl (2008), the AIDS treatment drive has a more commercial tag attached to it. Cardoso’s ideology also focuses on the aspect of commercialism of the treatment where citizens are viewed as customers rather than as people with needs. The expansion and the monopoly of the pharmaceutical market by the developed countries give superior bargaining power to these countries to exploit poor countries (Stiglitz & Charlton 2006). Another aspect that pharmaceutical companies exploit that draws away attention from the structural circumstance is the promotion of low-cost research in low and middle income countries. States as a result often do not take responsibility of providing health care to people, and people are often subject to aggressive campaigning by these companies (Davies 2010). Moreover circumstances that may draw attention away from treating the current disease include political and ethical issues. The government may not have much political will to tackle the problem at hand, and corruption of government officials and poor quality pharmaceutical drugs are playing a role in impeding the use resources in developing vaccines (OECD 2008). The exploitation of poorer countries by affluent pharmaceutical companies is unjust (Mack, Schramm, & Klasen, 2009). Blood donation is a key theme of medical treatments. The social aspect of blood donation is vast. Blood donation is considered a selfless act; the serving of the needs of the community and being altruistic is thought of as an exalted trait. The door and the recipient form a connection, one that surpasses the commercial and materialistic elements of donation. However, blood donation has attracted its own set of bio-politics. One of the problems that surfaces due to blood transfusions is the health risk it poses if the blood has not been screened. Blood transfusions are a major cause of HIV spread nowadays. Consequently many potential blood donors are discouraged from donating blood. This might be the case for gay men as well. In many countries, legislations exist against the donation of blood by gay men. Men who have sexual relations with other men are considered to be at a higher risk to HIV/AIDS. Although screening for HIV is available, it is not completely reliable because of the limitations of the tests to detect the infection. Therefore, many countries exclude gay men from donating blood due to the potential risk that might still be there after the screening has been negative. Gay men consider this ban discriminatory. Many of them consider it as a clash of their identity and sexuality with the prejudiced notions of the governments. Therefore many gay activists are valiantly involved in fighting for the freedom to donate blood despite their sexual preferences. These movements have gained momentum over the years and press for the exclusion of same-gender identity from the concept of HIV. Blood donations link the society with sexual minorities. Thomas Strong (2009) introduces the concept of vital publics in the arena of cultural intimacy. Vital publics are the sets of interactions that of people who are involved in the blood donation process. Strong (2009) asserts that these interactions elicit the connection associated with the exchange of body, in this case, blood. Focus on gay activism and the preclusion of gay men from donating blood has implications on the overall social circumstance. The governments are involved in solving the disputes of the gay activists that there is relatively less focus on the treatment of AIDS itself. Instead of precluding gay men from donating, governments should be focusing more on high-risk groups on the whole, which include IV drug users and carriers of HIV. The general public is at an equal risk of contracting AIDS through promiscuous sexual behavior and used injections and syringes. New technologies that provide more accurate HIV testing and recent studies on the spread of HIV have indicated that the risks involved in gay men to donate blood are very small (Busch, 2006). When the risk from HIV contamination by gay men is minimal, the governments are spending too much time and energy on an issue that is not of much significance. In lieu of addressing these concerns on the whole, the stress on curbing the donating rights of the gays detracts resources from being utilized in limiting the spread of HIV through other sources. The process of blood donation involves the drawing of gifts from the community. If the donors are relatives, blood donation fosters even more feelings of belonging and connection between the donor and the recipient. Blood donation is a visible process. One can see the blood trickling down the IV lines. Where operations and surgical procedures are performed within the walls of the operation theatre, the blood donation process entails complete visibility. However, the aspect of uncertainty about the results is common to both operations and blood donations. These elements have a direct effect on the social perception of the patient. Patients feel socially insignificant if relatives and kinship do not come to visit them when they have been admitted in the hospital. Also, in communities where high value is placed on families and kinship ties, it becomes routine to see relatives pouring in large numbers to see the patient and boast up his or her morale. In many hospitals, professionals have exploited this relationship and have made relatives donate blood on order to fill up their blood stores (Street, 2009). This hypocritical action reaffirms the doubts in the minds of the donors and the recipients that they are being exploited; such doubts diminish the focus on the real matter, and more effort and energy are concentrated on satisfying the patient. Another element of blood donation is voluntary anonymous blood donation. According to Elhence (2006), “the act of transfusion medicine takes into account many of ethical consideration since blood is taken from human beings and is a valuable source with a very restricted shelf life”. These cultural and social customs are significant when considering blood donations since government interventions in the donation process can tamper with these values. From a social and anthropological perspective, voluntary anonymous blood donations instill a connection between the recipient and the donor. They foster a moral relationship with people they do not know. However, voluntary blood donations are lower in ratio to donations by kin. This is partly attributable to the charges that the government has imposed in many countries on blood transfusions. Patients have not only complained of high fees, but many donors have refused to donate blood because of the commercial exploitation done by the government. This too has had adverse effects on the essence of blood donation. Many donors are also concerned about the transparency of the process, and fear that they will be involved in a relationship that does not benefit them (Street, 2009). Thus, in this case too, an emphasis on the ethical issues draws focus away from the central issue. Voluntary blood donation is considered to be modern in nature. The refusal to donate blood is in effect a refusal to be modern (Copeman, 2009). If the country is able to meet the demands of blood, it is indicative of the success of the government at procuring blood and the modernity of the individuals. The Zimbabwe’s National Blood Transfusion Service to procure and screen blood is not functional in its entirety because of the poor economic conditions that the country is plunged in. People in Iraq are also selling their blood; such dire circumstances illustrate the socio-economic situation of the country. Thus, in order to improve the blood donation capacity of the country, authorities need to deal with the gradation of the economic conditions. This can only be brought about if the governments direct their resources for the amelioration of social and economic state of the nations. Blood is increasing being seen for its commercial value. It is being viewed as a product or a good. The black market for the illegal trade of blood has flourished, and points to the commercialization of the process. Although many urban Chinese consider the practice of donating blood as a social obligation, their donation practice remains highly dependent on the incentives that they get in return (Erwin, Adams & Le, 200). These incentives may include time off from work, monetary rewards and the fulfillment of workplace quotas. This represents the change in attitudes of the people with greater consideration of their individualistic concerns and the rise of a postsocialist urban class in China. The ever-increasing demand for blood makes it necessary that there are a maximum number of donors. Therefore China put a certain amount of quota on employees that makes it mandatory to donate blood. Therefore, keeping these in mind, many employees do not donate blood with the intention of promoting the gift relationship that encompasses the spiritual bond between the recipient and the donor; rather, their motives are individualist in nature. There is a paradox existing in blood donation in China. Authorities are trying to propagate the socialist trends present in the society that inculcates a caring and considerate attitude to people who need blood; concurrently the authorities mitigate the spiritual aspect of blood donation by offering people incentives like food, financial rewards, credits for job etc. the individualist intentions of these people impedes the process if blood donation, and in building up enough stores of blood to meet the needs of the society. With the rapid pace of development, biotechnology has made the current era more individualistic (Strathern, 2005). Medical stem cell research and genetic technology are debatable topics. However, even in fertility clinics, there absolute individualism is not present. These institutions have a certain degree of kin involvement. Many couples receive sperm donations from relatives. However, this has led to its own set of problems. Relatives can assert for their right on the child and can detract the focus on genetic technology to their individualistic motives. With medical practice, the issues of bioethics gain importance. New research and technology necessitates the formulation of a code of ethics that comprehensively provides a code of conduct for professionals to follow. It is vital to have such a code of conduct because advances in technology have redefined the realms of possibility. Infertility was once considered an end to the reproductive cycle of an individual. However inventions of drugs and research into surgical procedures that can eliminate infertility have turned the dreams of having children by infertile couples into reality. Moreover, ground-breaking research in the field of stem cell research and genetic technology has contributed greatly to pushing the horizons of thought farther. Innovations in gene technology include researches on the development of genetic tests for children and adults alike, for embryos and unfertilized ova for identifying variations at the level of single-nucleotide polymorphism (Rose, 2007). Therefore, when conducting such researches and procedures, questions are addressed on to the correct way of performance. The issues surrounding them include if the procedures are humane and do not desecrate the sanctity of human life and if permissions have been taken before performing the procedures. Patients should know the implications of a medical procedure that they are going to undertake. If the doctor hides information and has not explained to the patient all the pertinent information regarding the procedure (Williams, 2007), then he is committing an unethical and illegal act. This forms basis of informed consent that is required in the heath care profession before practicing any procedure. As biomedical technique has extended choice to the existence of an individual, the world today faces the task of deliberating about the worth of human lives (Rose, 2007). Controversies and debate about who should be making decisions, as in the case of Euthanasia and stem cell research, as well as the actions of professionals that fall under the heading of unethical are central to new research. Somatic ethics and genetic capital also entail their own set of bioethics. The main argument is that if everyone is born equal, than why are some human live more valuable than others. There are some ways of living that are more in demand and sought after. Somatic ethics refers to the ethics that is inherent in individuals. Rose (2007) asserts that we are increasingly coming to relate ourselves to somatic individuals- beings whose individuality is grounded within our fleshly, corporeal existence and helps them act, and judge themselves in part in the language of biomedicine. Thus, it is expected of individuals to show a certain degree of moral obligation. The genetic capital, that is, specific to a certain lineage, can create differences in the community. Biological citizens need to reformulate their answers to Kant’s three famous questions- What can I know? What must I do? What may I hope?- in the era of medical bio-politics of life itself (Rose, 2007). The role of pharmaceutical industries in bio-politics is significant to market scientific discoveries. The market has strong influences and ties on the marketing of scientific innovations. This requires biocapital and is an integral component in the funding of research projects. Therefore, if enough capital is not available, the research would be affected and will not be able to reach conclusive stages. Consumer genomics have also come into play with the advances in technology. It presents a hierarchal industry where every one of us is a potential consumer. Genomic research has provided insight into the possible diseases that will surge in the near future. It also provides with a whole new level of drug administration: individualized medicine. Individualized medicine means the tailoring of the composition of a drug according to the genetic make-up of the person, such that the drug is more effective. Both genomic and its pharmacological derivatives are gaining popularity because they highlight the illnesses that may be rampant in the society in the future and market drugs that are effective and tailored to individual needs. It has a lot of scope, but its research raises ethical issues. It has been seen that the resource of third-world countries have been colonized by developed countries. The resources in question are the medical records and the genetic information of test subjects of researches being conducted by developed countries in poor countries (Rajan, 2005). The capitalistic approach of these countries takes the main focus on the development and enhancement of the field of study. Therefore, these countries would soon find themselves embroiled in cases and file suits about exploitation and abuse of resources. Since money is always limited in research projects, and economics classifies money as a scarce resource, capital for research would instead be spent in dealing with the law. Such activities will utilize the company’s capital and resources in other endeavors that do not support the main objective the company set out to achieve. The humanitarian complex that has emerged around AIDS has grown to include a heterogeneous and uneven collection of practices that have produced particular forms of subjects (Nguyen, 2004). This has caused the diversion of attention and resources to focus on problems other than curbing the spread of AIDS. Therapy is transactional in nature, with the doctor giving out prescriptions and the patient receiving it in return for some monetary payment. Nguyen (2004) discusses how such moral economies draw attention away from the philosophy of the process. This is done by focusing more on the limitations of the therapeutic process. Moreover, humanistic interventions in the process of treatment of AIDS can lead to the focus shifting form the main purpose to ancillary issues. Many of the humanitarian group members are either carriers or tested positive for the advanced stages of the disease (Nguyen, 2004). Therefore, their individual motives for accessing treatment and using it for their own purpose can hinder the delivery of treatment to the general population. The treatment of AIDS has its share of bio-politics as well. Since not everyone can easily access treatment, this inequity can be exploited by pharmaceutical industries to their own advantage. These subjects can provide these industries with a potential market for research and experiments. Trials can be conducted by them on the less-privileged in return for some monetary incentive or the success of the experiments. The proliferating market power of pharmaceutical industries poses a threat to the widespread delivery of HIV treatment. The pharmacological treatments that are favored by the pool of patents can have adverse effects too. Patent barriers can prevent innovation for instance new pediatric formulations and the much-needed dose combinations that impact the treatment offered to people infected with HIV (Bonnet, 2009). Alliances among AID activists, governments, philanthropists and international agencies well as pharmaceutical agencies have led to more access to antiretroviral drugs; however this has crystallized new equalities (Biehl, 2008). When the government in Brazil makes counteracting a disease its first priority, it is the cue for pharmaceutical industries to research in new drugs for treating the disease. Pharmaceutical companies restructure their operational framework in the production of drugs that are more expensive and deliver better results. The government acts as the buyer and distributor of these drugs. If the drugs have little efficacy, the role of the government would be reduced to a mere commercial agent in the delivery of drugs that have minimal effect on the targeted issues. Therefore, it is often seen that health interventions by pharmaceutical companies ‘are not comprehensive and ultimately of poor quality’. The debate that subsequently emerges circles around the long-term viability of these endeavors and their operability in the situation where no regulatory authority is present. Patients are actively involved in the process of drug selection. Patients are consumers that actively choose and use medicine, pharmaceuticals and biosciences in order to maximize and promote their own vitality (Rose, 2007). Since the drugs are high-priced, the development of low-priced drugs that can be afforded by a large majority of the population is not given due importance. The general public will feel dissatisfied if the drugs are not giving productive results despite the large amount of money they have invested in purchasing them. Hence, the focus on pharmaceutical treatments has detracted the government from developing cheaper drugs that could be of greater benefit for the general public. Moreover, allowing a few pharmaceutical industries to operate gives them a large share of the market. Another implication of encouraging a limited number of drugs to be produced is that individuals who become resistant to the available drugs do not have any other option. Therefore, a government strategy that promotes only a limited number of expensive treatment options is not feasible. Thus, in conclusion, treatment options by pharmaceutical industries attract debates on bio-politics. Researches today have shifted the clinical gaze from gross anatomy to the molecular level. Molecular bio-politics concerns all ways in which the regulation and ethics of life may be mobilized and organized into patterns that did not exist in the yore (Rose, 2007). Blood donations give rise to many ethical issues, with patients’ reservations on the transparency of the process and the relationship of the recipient and the donor. A focus on the ethical considerations of the blood donation process is attention-seeking. The main objective of blood banks is to meet the requirements of the needs of the health care institutions. If the authorities have to maintain a smooth flow of the organizations, they need to remove the barriers to effective treatment. The doubts of the donors and their complaints against the commercial exploitation also constitute part of the pharmaceutical treatment. Governments, thus, have to reformulate their directives to address the ethical limitations of the pharmaceutical treatments. Moreover, the development of drugs that are expensive do little to satisfy the public. This creates tension since people who are paying large amounts of money to pacify their conditions are not content by the service being offered. Subsequently, the concentration of resources on treatment options by pharmaceutical companies leads to negative effects, and the main purpose of all this painstaking process is not achieved. The HIV/AIDS has attracted intense debate especially regarding the transnational pharmaceutical companies (Hayray, Takala & Herissone-Kelly, 2007). Focus on pharmaceutical treatments, thus, deploys resources into unimportant activities that prevent the achievement of the chief goal. 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