Seaman Rachel M H
J Okla State Med Assoc. 2005 Jan;98(1):22-6.
Many U.S. citizens are unable to afford prescription medication in their own country, so they purchase them from Canadian pharmacies. This paper examines the ethics of importing drugs from Canada, including economic implications and how physicians should respond to this dilemma. The four basic principles of ethics are balanced by examining financial incentives, current Canadian and U.S. law, safety issues, the burden of research and development, the impact on Canadian physicians, and issues of liability. The paper concludes that the principle of autonomy permits individuals to cross the border and purchase drugs for personal use; however, nonmaleficence prohibits the purchase of these drugs through third parties. In addition, the U.S. government has special obligations to justice and beneficence and may not ethically sponsor the importation of Canadian drugs. Finally, the paper shows that U.S. doctors must not recommend importation on the basis of beneficence and autonomy.
许多美国公民在本国买不起处方药，于是他们从加拿大药房购买。本文探讨了从加拿大进口药品的伦理问题，包括经济影响以及医生应如何应对这一困境。通过审视经济激励因素、加拿大和美国现行法律、安全问题、研发负担、对加拿大医生的影响以及责任问题，对四项基本伦理原则进行了权衡。本文得出结论，自主原则允许个人越境购买药品供个人使用；然而，不伤害原则禁止通过第三方购买这些药品。此外，美国政府对公正和慈善负有特殊义务，从伦理角度讲不得支持进口加拿大药品。最后，本文表明美国医生不得基于慈善和自主原则推荐进口药品。
