I mean yes, sure, I realize the author blames himself for the death of that poor girl. But how could he possibly have known? It's neither his job nor his responsibility to know anything about the side effects of this drug. His job was to built a website, according to the wishes of his employer. And so he did.
Hindsight is 20/20, it's easy to say afterwards that what he did was unethical. But to me this seems more like bad luck.
On the other hand... as a general rule, I don't really want software developers deciding what to code based on their personal medical opinions. That can cut both ways.
If the author felt it was unethical at the time (and he says it didn't really cross his mind), the best he could have done would have been to quit. Then, of course, someone else would have taken his place. Perhaps his conscience would have been cleaner, but I doubt any girls would have been saved. The stark reality is that ethical quandaries like this call for an all-or-nothing approach; either you're disturbed enough to report their actions to the authorities, or you don't do anything at all. You can quit, but that won't save anyone, so you're not really helping. (Unless you're irreplaceable, of course.)
There's another important element to the author's story: the sketchy questionnaire and the drug's harmful side effects weren't really linked in any way. Marketing is marketing; as the author says, he knew the job of the site was to promote the drug. Shady questionnaire or not, that's not inherently problematic. If the pharma company misled its customers on the side effects or knew the drug wasn't safe, that's an entirely separate issue that the author simply could not have known of. Drugs are complicated business, and they can be helpful, dangerous, important, and abused all at the same time.
The "last line of defense" statement was a powerful one, but not one I feel I can really agree with. It's often said that pharmacists are the last line of defense for prescription drugs, and that's how it should be; they actually have the training to know what they're doing. Software engineers might be a knowledgeable bunch, but they're not so knowledgeable they should be making calls outside their expertise.
With regards to advertising, I'm from the UK so we don't get much medical advertising, but in the US it is crazy. Half the adverts in commercial breaks seem to be for medicines with half a dozen potential side effects.
> Then, if a visitor could prove they had a prescription, they were given access to a patient portal with more specific info about the drug.
I assume that it was just further information about the drug. In the UK only a doctor can prescribe controlled medicines. I assume it's the same in Canada... if so it's for the doctor, who has had years of training in this field, to prescribe the correct drug. Yes, some drugs cause side effects for some people, and medicines need to be adjusted/changed as a result. We don't know how many people died as a result of the medicine, but that's what government regulation should deal with not allowing untested drugs to be sold.
> We’re approaching a time where software will drive the vehicle that transports your family to soccer practice. There are already AI programs that help doctors diagnose disease. It’s not hard to imagine them recommending prescription drugs soon, too.
For me this was the most (and only) important paragraph of the post.
However, I should add that: > Perhaps his conscience would have been cleaner Is a big deal. Obviously, it is up to the individual to determine the proper course of action for themselves, but I disagree with the line of thought that 'you should stay in unethical situations because someone else will be there and at least this way you can create change.' Rather, you ought to act authentically and with honestly.
"The authentic human being is one of us who instinctively knows what he should not do, and, in addition, he will balk at doing it. He will refuse to do it, even if this brings down dread consequences to him and to those whom he loves. This, to me, is the ultimately heroic trait of ordinary people; they say no to the tyrant and they calmly take the consequences of this resistance. Their deeds may be small, and almost always unnoticed, unmarked by history. Their names are not remembered, nor did these authentic humans expect their names to be remembered. I see their authenticity in an odd way: not in their willingness to perform great heroic deeds but in their quiet refusals. In essence, they cannot be compelled to be what they are not."
-Philip K Dick
The survey is a trick to make the site look unbiased. To look like it just happened to tell you to take that particular drug from that particular company, with other options available if you selected different things.
The ethical way to implement it would have been to just have a website that was obviously by that company, no survey, just saying "do you have problems with {x}/{y}/{z}? {Our product} may be right for you. Not to be taken if you have {some allergies etc}."