Hope Exploitation in Pharmaceutical Promotion: Ethical Dimensions and Policy Implications of the Promotion of Opioids in the US and Canada

Jeremy Snyder

Abstract: Hope plays an important role in patient care, offering patients strength and optimism during difficult times of illness or injury. However, the promotion of hope can have negative effects as well, as it can create exaggerated expectations and make patients vulnerable to exploitation from caregivers and medical professionals. Hope exploitation is particularly significant for vulnerable individuals with terminal illnesses and chronic debilitating diseases, who may be more desperate for a cure or improved prognosis. Scholars investigating hope exploitation have focused on its meaning and the vulnerabilities it creates. However, scholars, including bioethicists and those studying the commercial determinants of health, have not yet adequately addressed how pharmaceutical companies have exploited hope in drug marketing and the ethical issues this exploitation raises.

This research investigates the ethics of opioid promotion in Canada and the US through the lens of hope exploitation, examining how opioid manufacturers have used this tactic to influence consumer preferences and physicians' prescribing behaviour and why it is ethically problematic. The study employs a framing analysis to examine how opioid manufacturers frame their products' safety and effectiveness to manipulate hope. It examines opioid advertisements, industry documents, and other primary sources to identify the strategies used to market opioids.

The knowledge generated in this study is expected to contribute significantly to the understanding of how hope exploitation is used by commercial actors in the Canadian and US health systems. It will offer ethical recommendations for the medical community and the pharmaceutical industry regarding the promotion of biomedical innovations.

Keywords: Hope exploitation, opioids, Vulnerable populations