THE INFLUENCE OF MORAL JUDGMENT ON PHYSICIANS' PRESCRIPTION BEHAVIOUR

  • Sardar Md Humayun Kabir Department of Business Administration, Faculty of Economics and Management Sciences, International Islamic University Malaysia
  • Suharni Maulan Department of Business Administration, Faculty of Economics and Management Sciences, International Islamic University Malaysia
  • Noor Hazilah Abd Manaf Department of Business Administration, Faculty of Economics and Management Sciences, International Islamic University Malaysia
  • Zaireena Wan Nasir 1Department of Business Administration, Faculty of Economics and Management Sciences, International Islamic University Malaysia
Keywords: Physicians’ prescription behaviour, Moral judgment, Ethical prescription practices, Moral equity, Private healthcare facilities, Malaysia

Abstract

Pharmaceutical promotion towards physicians’ prescription behaviour is strongly interrelated. Identifying and addressing the ethical challenges in physicians’ prescription behaviour to increase the ethical predisposition of prescribing medicines is prioritized in global health and development plans. Hence, the importance of ethics in the professionalism of healthcare practitioners is now a growing concern. The main objective of this research is to investigate the influence of moral judgment on physicians' prescription behaviour. A survey has been conducted among 152 medical practitioners from private healthcare facilities in the metropolitan area of Kuala Lumpur and Selangor states of Malaysia. The principal component analysis method in EFA and structural equation modelling technique in CFA has been used to analyze the data and validate the model. The study found that physicians’ moral equity factor has a significant and positive influence on physicians’ prescription behaviour whereas their relativism and contractualism factors were not significant. The empirical evidence obtained from this study would make significant contributions to advancing the current knowledge of ethical prescription behaviour. Recommendations to physicians for more ethical prescription practices have been discussed at the end of this paper.

References

James C, Peabody J, Solon O, et al. An unhealthy public-private tension: Pharmacy ownership, prescribing, and spending in the Philippines. Health affairs 2009; 28(4):1022-1033.

Shamim-ul-Haq S, Ahmed RR, Ahmad N, et al. Factors Influencing Prescription Behavior of Physicians. The Pharma Innovation Journal 2014; 3(5):30-35.

Ali MM, Mohaidin Z, Models and theories of prescribing decisions: A review and suggested a new model. Pharmacy Practice 2017; 15(2):990.

Wei M, Delbaere M, Do consumers perceive their doctors as influenced by pharmaceutical marketing communications? A persuasion knowledge perspective. International journal of pharmaceutical and healthcare marketing 2015; 9(4):330–348.

Khazzaka M, Pharmaceutical marketing strategies' influence on physicians' prescribing pattern in Lebanon: Ethics, gifts, and samples. BMC Health Services Research 2019; 19(1):1-11.

Skandrani H, Sghaier M, The dark side of the pharmaceutical industry. Marketing intelligence & planning 2016; 34(7):905-926.

Fickweiler F, Fickweiler W, Urbach E, Interactions between physicians and the pharmaceutical industry generally and sales representatives specifically and their association with physicians' attitudes and prescribing habits: A systematic review. BMJ Open 2017; 7(9):e016408. doi:10.1136/bmjopen-2017-016408

Alves TL, Lexchin J, Mintzes B, Medicines Information and the Regulation of the Promotion of Pharmaceuticals. Science and Engineering Ethics 2019; 25(4):1167-1192.

Statista Report (2015). Revenue of the worldwide pharmaceutical market from 2001 to 2015 (in billion U.S. dollar). Retrieved from:

https://www.statista.com/statistics/263102/pharmaceutical-market-worldwide-revenue-since-2001/

Lexchin J, Pharmaceutical company spending on research and development and promotion in Canada, 2013-2016: a cohort analysis. Journal of Pharmaceutical Policy and Practice 2018; 11(5):1–6.

Weiss J, Medical marketing in the United States: A prescription for reform. The George Washington law review 2010; 79(1):260-292.

Zaki NM, Pharmacists' and physicians' perception and exposure to drug promotion: A Saudi study. Saudi pharmaceutical journal: the official publication of the Saudi Pharmaceutical Society 2014; 22(6):528–536. https://doi.org/10.1016/j.jsps.2014.02.008

Hirschler B, Bribery scandal slashes GlaxoSmithKline's Chinese drug sales. Thomson Reuters 2013; 23 October.

Latten T, Westra D, Angeli F, et al. Pharmaceutical companies and healthcare providers: Going beyond the gift: An explorative review. PLoS one 2018; 13(2):e0191856.

Sanyal SN, Datta SK, Banerjee AK, Factors influencing prescribing decisions among physicians: an empirical study on generic drugs. International Journal of Pharmaceutical and Healthcare Marketing 2017; 11(4):330-360.

Ladeira W, Dalmoro M, Maehler A, et al. Drug prescription practices in Brazil: A structural equation model. International Journal of Pharmaceutical and Healthcare Marketing 2011; 5(4):262-278.

Waheed KA, Jaleel M, Laeequddin M, Prescription loyalty behavior of physicians: an empirical study in India. International Journal of Pharmaceutical and Healthcare Marketing 2011; 5(4):279-298.

Campo K, De Staebel O, Gijsbrechts E, et al. Physicians’ decision process for drug prescription and the impact of pharmaceutical marketing mix instruments. Health marketing quarterly 2005; 22(4):73-107.

Abratt R, Lanteigne J, Factors influencing general practitioners in the prescription of homeopathic medicines. South African Journal of Business Management 2000; 31(3):91-97.

Brewster J, What information sources do physicians value for staying abreast of new medical developments?. Kantar Media 2014.

Garrigan B, Adlam ALR, Langdon PE, Moral decision-making and moral development: Toward an integrative framework. Developmental review 2018; 49(March):80–100.

Rest JR, Moral development: Advances in research and theory. New York: Praeger 1986.

Kohlberg L, The philosophy of moral development. San Francisco: Harper & Row 1981.

Reynolds SJ, Ceranic TL, The effects of moral judgment and moral identity on moral behavior: An empirical examination of the moral individual. The Journal of applied psychology 2007; 92(6):1610–1624. https://doi.org/10.1037/0021-9010.92.6.1610

Baron MW, Pettit P, Slote M, Three methods in ethics. Malden: Blackwell Publishers Inc 1997.

Premeaux SR, The current link between management behavior and ethical philosophy. Journal of business ethics 2004; 51(May):269-278.

Lahdesmati M, When ethics matters – interpreting the ethical discourse of small nature – based entrepreneurs. Journal of business ethics 2005; 61(1):55-68.

Kant I, Groundwork of the metaphysics of morals. Edited by Mary Gregor. Cambridge: Cambridge University Press 1998.

Reidenbach RE, Robin DP, Some initial steps toward improving the measurement of ethical evaluations of marketing activities. Journal of business ethics 1988; 7(11):871-879.

Granitz N, Loewy D, Applying ethical theories: Interpreting and responsibility to student plagiarism. Journal of business ethics 2007; 72(3):293-306.

Victor B, Cullen JB, The organizational bases of ethical work climates. Administrative science quarterly 1988; 33(1):101-125.

Pettifor JL, Estay I, Paque S, Preferred strategies for learning ethics in the practice of a discipline. Canadian psychology 2000; 43(4):260-269.

Trevino LK, Moral reasoning and business ethics: Implications for research, education and management. Journal of business ethics 1992; 11(5/6):445-459.

Bartels DM, Bauman CW, Cushman FA, et al. Moral Judgment and Decision Making. In: G. Keren & G. Wu (Eds.) Blackwell Reader of Judgment and Decision Making. Malden, MA: Blackwell 2014.

Trevino LK, Weaver GR, Reynolds SJ, Behavioral ethics in organizations: A review. Journal of management 2006; 32(6):951–990.

Kant I, Ethical philosophy. 2nd ed., J. W. Ellington, Trans. Indianapolis, IN: Hackett Publishing 1994.

Reidenbach R, Robin D, Toward the development of a multi-dimensional scale for improving evaluations of business ethics. Journal of Business Ethics 1990; 9:639-653.

Gupta S, A multidimensional ethics scale for Indian managers' moral decision making. Electronic Journal of Business Ethics and Organization Studies 2010; 15(1):5-14.

Ajzen I, Fishbein M, Understanding attitude and predicting social behavior. Englewood Cliffs, NJ: Prentice Hall 1980.

Hunt S, Vitell S, A general theory of marketing ethics. Journal of micromarketing 1986; 6(1):5-16.

Khan N, Naqvi A, Ahmad R, et al. Perceptions and attitudes of medical sales representatives (MSRs) and prescribers regarding pharmaceutical sales promotion and prescribing practices in Pakistan. Journal of young pharmacists 2016; 8(3):244-250. 10.5530/jyp.2016.3.13.

Rahman MK, Khan AH, Jalil A, Ethical implications of sales promotion in Malaysia. Islamic perspective 2014; 2(1):13–27.

Mohiuddin M, Rashid SF, Shuvro MI, et al. Qualitative insights into promotion of pharmaceutical products in Bangladesh: how ethical are the practices?. BMC medical ethics 2015; 16(1):80. https://doi.org/10.1186/s12910-015-0075-z

Allman RL, The relationship between physicians and the pharmaceutical industry: ethical problems with the every-day conflict of interest. HEC forum: An interdisciplinary journal on hospitals' ethical and legal issues 2003; 15(2):155–170. https://doi.org/10.1023/a:1024901008495

Sillup GP, Porth SJ, Ethical issues in the pharmaceutical industry: An analysis of US newspapers. International journal of pharmaceutical and healthcare marketing 2008; 2(3):163-180.

Kant I, Critique of pure reason. Edited by Paul Guyer and Allen W. Woods. Cambridge: Cambridge University Press 1998a.

Guglielmo S, Moral judgment as information processing: an integrative review. Frontiers in psychology 2015; 6:1637. https://doi.org/10.3389/fpsyg.2015.01637

MOH: Malaysian statistics on medicines (2011 – 2014). Ministry of Health, Pharmaceutical Services Division 2017.

Vancelik S, Beyhun NE, Acemoglu H, et al. Impact of pharmaceutical promotion on prescribing decisions of general practitioners in Eastern Turkey. BMC Public Health 2007; 7(122):1-8.

Love E, Salinas TC, Rotman JD, The ethical standards of judgment questionnaire : Development and validation of independent measures of formalism and consequentialism. Journal of business ethics 2018; 161(1):115-132.

Grimm P, Social desirability bias. In: Wiley International Encyclopedia of Marketing (eds J. Sheth and N. Malhotra) 2010. doi:10.1002/9781444316568.wiem02057

Hair JF, Black WC, Babin BJ, et al. Multivariate data analysis (Seven ed.). Upper Saddle River, NJ Prentice Hall: Pearson 2010.

Frohlich MT, Westbrook R, Arcs of integration: An international study of supply chain strategies. Journal of Operations Management 2001; 19:185–200. https://doi.org/10.1016/S0272-6963(00)00055-3

Chua YP, Ujian Regresi, Analisis Faktor, dan Analisis SEM. Shah Alam: McGraw Hill Education 2014.

Kenny DA, Kaniskan B, McCoach DB, The performance of RMSEA in models with small degrees of freedom. Sociological Methods & Research 2015; 44(3):486–507. https://doi.org/10.1177/0049124114543236

Hair JF, Black B, Babin BJ, et al. Multivariate Data Analysis 6th Edition. Pearson International Edition 2006.

Fornell C, Larcker DF, Evaluating structural equation models with unobservable variables and measurement error. Journal of Marketing Research 1981; 18(1):39-50.

Schaefer GO, Savulescu J, Better minds, better morals: A procedural guide to better judgment. Journal of posthuman studies: philosophy, technology, media 2017; 1(1):26–43. https://doi.org/10.5325/jpoststud.1.1.0026

Othman N, Vitry AI, Roughead EE, et al. Doctors’ Views on The Quality Of Claims Provided By Pharmaceutical Representatives: A Comparative Study In Malaysia And Australia. Journal of Taibah University Medical Sciences 2015; 10(4):471-480.

Published
2021-12-28
How to Cite
Sardar Md Humayun Kabir, Suharni Maulan, Manaf, N. H. A., & Nasir, Z. W. (2021). THE INFLUENCE OF MORAL JUDGMENT ON PHYSICIANS’ PRESCRIPTION BEHAVIOUR. Malaysian Journal of Public Health Medicine, 21(3), 96-105. https://doi.org/10.37268/mjphm/vol.21/no.3/art.1063