Many people believe that the research-based
pharmaceutical industry has a ‘special’ moral obligation to
provide lifesaving medications to the needy, either free-ofcharge
or at a reduced rate relative to the cost of manufacture.
In this essay, I argue that we can explain the ubiquitous
notion of a special moral obligation as an expression of
emotionally charged intuitions involving sacred or protected
values and an aversive response to betrayal in an asymmetric
trust relationship. I then review the most common arguments
used to justify the claim that the pharmaceutical industry has
a special moral obligation and show why these justifications
fail. Taken together, these conclusions call into question the
conventional ideologies that have traditionally animated the
debate on whether the pharmaceutical industry has special
duties of beneficence and distributive justice with respect to
the impoverished in dire need of their products.