Pharmaceutical Promotion, Physician Ethics, and Patient Welfare: A Principlism-Based Analysis in Bangladesh

Abstract

The relationship between pharmaceutical companies and physicians plays a critical role in shaping prescribing practices and healthcare outcomes, particularly in developing countries such as Bangladesh. This study examines the ethical implications of pharmaceutical promotion through the lens of principlism, focusing on autonomy, beneficence, nonmaleficence, and justice. Drawing on existing literature, policy documents, and contextual evidence from Bangladesh, the paper analyzes how gift culture, financial incentives, and aggressive marketing strategies influence physicians’ clinical decision-making. The findings suggest that such practices often create conflicts of interest, compromise professional ethics, and increase healthcare costs borne by patients through out-of-pocket expenditures. The study further highlights regulatory gaps and weak enforcement mechanisms that allow unethical promotional activities to persist. By critically assessing the pharma–physician alliance, the paper underscores the need for stronger healthcare and pharmaceutical marketing regulations to protect patient welfare and restore trust in the medical profession. The study contributes to bioethics and health policy discourse by offering policy-relevant insights for ensuring ethical medical practice and equitable healthcare delivery in Bangladesh