Navigating ethical challenges faced by professionals within the pharmaceutical industry in Malta

Abstract

Objective The pharmaceutical industry operates at the intersection of medical innovation and commercial profit, creating a dual mission that poses significant ethical challenges. Apart from identifying the practices within the local pharmaceutical sector that cause most concern, this dissertation investigates the ethical orientation, recognition of ethical breaches, and levels of moral distress among pharmaceutical professionals in Malta and which factors bear most impact on the traits under investigation. Method Utilizing a quantitative research design, an anonymous online questionnaire was distributed to members of the Association of Medical Representatives (AMR), the central organization for medical representatives in Malta. The research employed the Ethics Position Questionnaire-5 (EPQ-5) to assess ethical orientation, vignette-based scenarios to measure recognition and tolerance of misconduct, and a scale composed of industry-specific items to evaluate moral distress. Key Findings Based on a response rate of 42.1%, findings indicate that marketing practices (70.3%) are perceived as the primary source of ethical concern. The local workforce is predominantly principled, with 39.1% classifying as Absolutists and 29.7% as Situationists, reflecting a collective priority on patient safety and harm avoidance. Ethics training appears to contribute significantly to ethical recognition, significantly improving a professional’s ability to identify misconduct such as misleading claims or the withholding of safety information. Notably, Maltese nationality was the strongest predictor of high moral distress, while pharmacists reported significantly higher distress than non-pharmacists, particularly regarding safety information and unethical incentives. Furthermore, a clear shift in ideology was observed with tenure, moving from Subjectivism at entry-level to Absolutism among more experienced professionals. Conclusion The study concludes that while the Maltese pharmaceutical workforce is fundamentally principled, individuals face significant distress when commercial pressures conflict with professional integrity.