One of the problems with any system of governance is that it contains flaws that cast shadows on the other elements, no matter how good they may be. I happen to believe that capitalism is the best of the systems so far developed for economic governance; but it, too, has its flaws, one of which is the tendency of businesses to argue that if something is legal, they're entitled to do it. Moral and ethical considerations aren't taken into account.
That's come home to roost in West Virginia in a big way.
In six years, drug wholesalers showered the state with 780 million hydrocodone and oxycodone pills, while 1,728 West Virginians fatally overdosed on those two painkillers, a Sunday Gazette-Mail investigation found.
The unfettered shipments amount to 433 pain pills for every man, woman and child in West Virginia.
“These numbers will shake even the most cynical observer,” said former Delegate Don Perdue, D-Wayne, a retired pharmacist who finished his term earlier this month. “Distributors have fed their greed on human frailties and to criminal effect. There is no excuse and should be no forgiveness.”
The Gazette-Mail obtained previously confidential drug shipping sales records sent by the U.S. Drug Enforcement Administration to West Virginia Attorney General Patrick Morrisey's office. The records disclose the number of pills sold to every pharmacy in the state and the drug companies' shipments to all 55 counties in West Virginia between 2007 and 2012.
The wholesalers and their lawyers fought to keep the sales numbers secret in previous court actions brought by the newspaper.
. . .
The nation's three largest prescription drug wholesalers — McKesson Corp., Cardinal Health and AmerisourceBergen Drug Co. — supplied more than half of all pain pills statewide.
For more than a decade, the same distributors disregarded rules to report suspicious orders for controlled substances in West Virginia to the state Board of Pharmacy, the Gazette-Mail found. And the board failed to enforce the same regulations that were on the books since 2001, while giving spotless inspection reviews to small-town pharmacies in the southern counties that ordered more pills than could possibly be taken by people who really needed medicine for pain.
As the fatalities mounted — hydrocodone and oxycodone overdose deaths increased 67 percent in West Virginia between 2007 and 2012 — the drug shippers' CEOs collected salaries and bonuses in the tens of millions of dollars. Their companies made billions. McKesson has grown into the fifth-largest corporation in America. The drug distributor's CEO was the nation's highest-paid executive in 2012, according to Forbes.
In court cases, the companies have repeatedly denied they played any role in the nation's pain-pill epidemic.
Their rebuttal goes like this: The wholesalers ship painkillers from drug manufacturers to licensed pharmacies. The pharmacies fill prescriptions from licensed doctors. The pills would never get in the hands of addicts and dealers if not for unscrupulous doctors who write illegal prescriptions.
In other words, don't blame the middleman.
. . .
“It starts with the doctor writing, the pharmacist filling and the wholesaler distributing. They're all three in bed together,” said Sam Suppa, a retired Charleston pharmacist who spent 60 years working at retail pharmacies in West Virginia. “The distributors knew what was going on. They just didn't care.”
. . .
The Big Three wholesalers together are nearly as large as Wal-Mart, with total revenues of more than $400 billion. Their revenues account for about 85 percent of the drug distribution market in the U.S.
There's more at the link.
Whether we like it or not, there is a moral and ethical dimension to many of the decisions we make. No matter what our system of belief (if any), we remain responsible for that. Examples:
- There is no legal requirement in most US states to store one's firearms in a safe manner, where children and casual thieves can't easily get at them. Nevertheless, I believe that if one fails to do so, and a child is injured or killed with one, or a thief steals one that he later uses to commit further crimes and threaten innocent lives, one bears some moral responsibility for failing in one's ethical duty of care.
- If one turns a blind eye to the misconduct of one's children, so that they grow up without any moral code or understanding of what is, and is not, acceptable behavior, one shares some responsibility for the damage and hurt they will inevitably inflict on others.
- If one sees conduct that is morally and/or ethically questionable, whether or not it's actually legal, I believe one has the responsibility to - at the very least - dissociate oneself from it. That may extend to resigning from one's job, rather than be linked to it by our presence. Silence is presumed consent. Areas such as shoddy workmanship hidden from the customer, trash-talking competitors . . . they're all ethically and morally wrong. If we associate ourselves with them by our presence and our silence, we share complicity in them.
The same applies to the epidemic of opioid abuse in West Virginia and elsewhere. If we become part of the conspiracy of silence, it doesn't help to argue that we don't abuse them ourselves, or provide them to abusers. We're still part of the conspiracy . . . and people are still suffering and dying because of it.
No man is an island,
Entire of itself,
Every man is a piece of the continent,
A part of the main.
If a clod be washed away by the sea,
Europe is the less.
As well as if a promontory were.
As well as if a manor of thy friend's
Or of thine own were:
Any man's death diminishes me,
Because I am involved in mankind,
And therefore never send to know for whom the bell tolls;
It tolls for thee.
- John Donne