medical ethics
September 11, 2018

The chief executive of Nostrum Laboratories won't let public shaming make him feel bad about raising the price of an antibiotic to $2,392 a bottle, from $474.75.

In an interview with the Financial Times, Nostrum CEO Nirmal Mulye defended his company's decision last month to hike the price of liquid nitrofurantoin by 400 percent. "I think it is a moral requirement to make money when you can," he said, "to sell the product for the highest price." Nitrofurantoin, an antibiotic that treats bladder infections, is deemed an essential medicine by the World Health Organization.

Mulye said he had to bump up the price in response to Casper Pharma, which makes the branded version of the antibiotic, increasing its price to $2,800. "The point here is the only other choice is the brand at the higher price," Mulye said. "It is still a saving regardless of whether it is a big one or not." He told FT he agreed with Martin "Pharma Bro" Shkreli raising the price of the AIDS and cancer drug Daraprim in 2015 to $750 per tablet, from $13.50, saying Shkreli was "within his rights because he had to reward his shareholders."

We live in a "capitalist economy and if you can't make money you can't stay in business," Mulye said. "We have to make money when we can. The prices of iPhones goes up, the price of cars goes up, hotel rooms are very expensive." In response, Food and Drug Administration Commissioner Scott Gottlieb tweeted there is "no moral imperative to price gouge and take advantage of patients." Catherine Garcia

September 18, 2016

A terminally ill 17-year-old in Belgium became the first minor euthanized after the country lifted age restrictions for voluntary euthanasia in 2014. The identity of the teenager and date of his or her death have not been released, though a Belgian official confirmed the euthanasia happened within the last week.

"Fortunately, there are very few children who are considered [for euthanasia], but that does not mean we should refuse them the right to a dignified death," said Wim Distelmans, head of Belgium's state euthanasia commission. Belgian law requires terminally ill children of any age to be conscious and possessed of "capacity of discernment" to request their own deaths, as well as permission from the minors' parent or guardian.

Physician-assisted suicide is legal under certain circumstances in five American states — California, Montana, Oregon, Vermont, and Washington — and promises to be a significant culture-war battle for years to come. Bonnie Kristian

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