Prescribing under the Influence: The Business of Breastmilk Substitutes

Abstract

This study draws on a general theoretical framework comprising of a decision maker (a doctor), perceived moral intensity of the issue (breastfeeding substitute prescription), and the situational environment (hospital policy, pharma company promotions, and mother’s beliefs regarding breastfeeding) to explain the physician’s role and influence on mothers’ infant feeding choices when prescribing infant formula in Kuwait, Middle East. Moral intensity is an issue-contingent model that suggests ethical decisions vary in terms of how much a moral imperative is present in a situation. The moral intensity of the issue is assessed using six components. Path Least Squares results indicate the following moral intensity components have significant impact on prescription behavior: magnitude of consequences, probability of effect, and temporal immediacy. Company promotion and hospital policy also significantly influence doctor’s prescription of infant formula. Doctors appear to disengage from the consequences of over prescribing infant formula.

Keywords

• over prescription
• breastfeeding
• medical ethics
• moral intensity
• hospital policy
• moral judgment