Case Study Report: Traidos Bank and Roche’s Drug Trials in China Traidos Bank was a small British

banking
institution which took pride in its success as “the world’s leading ethical and sustainable bank” (Velasquez
p.143). Traidos made all day-to-day decisions based on six principles. Those principles were: promoting
sustainable development, respecting and obeying the law, respecting human rights, respecting the environment,
being accountable, and continuously improving. In addition to offering various accounts, Traidos also offered
their clients investment opportunities in thirteen different portfolios. The return on these funds were reinvested
in businesses that were “sustainable” and in line with Traidos’ strict principles (Velasquez p. 143). Roche was
a large pharmaceutical company that was brought into Traidos’ portfolio investments in 2009 because it was
believed that Roche met Traidos’ ethical criteria. Despite, initially, meeting the strict ethical criteria set by
Traidos, in 2010, it was revealed that Roche was conducting clinical trials in China concerning an antirejection
drug called CellCept. It was discovered that those drug trials violated the rules and guidelines that Traidos
operated under. A requirement in China for any drug sold in their country is that it must be tested on Chinese
people. Roche, while obeying Chinese laws, was conducting the required clinical trials on patients who
received their transplanted organs primarily from recently deceased prison inmates in China. Almost 90
percent of those deceased inmates were executed prisoners. Further, it was exposed that many of these inmates
were made to execute an organ donor release form, or there was no form signed at all. Therefore, most of the
transplanted organs were believed to have been obtained illegally.

Traidos Bank and Roche’s Drug Trials in China Utilitarianism evaluates an action by the benefits and costs
that the action produce for everyone in society. Roche was following the Chinese laws. He was first testing the
drugs on Chinese patients. Roche was developing a drug that would benefit the Chinese society. Roche had no
control over how the organs were harvested. Knowing or not where the organs were originating from wouldn't
be as important, as long as their end goal of saving lives would be completed. The conditions of this study are
questionable regarding rights-based ethic. There is no way of knowing if the prisoner would have volunteered
or declined to be part of donating its organs. There is also impossible to know under what conditions the
organs were removed from the prisoners. If there were proves that organs were taken against prisoners will
under unhealthy conditions, then is safe to say that is was unethical by moral standards but since there is no…

A Case Study of Roche’s Drug Trials in China Essay Sample

In business we must evaluate decisions along ethical lines and we must recognize that,
for the long-term benefit of society, we cannot always make these decisions based simply
upon a profit motive. The following case exemplifies the complexities inherent in business
decisions. The case examined addresses whether it is worth doing something ethically
questionable for the sake of a justified end. In 2010, the pharmaceutical company Roche
came under fire from Traidos Bank, the Berne Declaration, Greenpeace, and other critics
for its policy of testing an organ transplantation drug called CellCept in China. CellCept is
a drug designed to “prevent the rejection of transplanted organs”, and has been used
successfully in many countries around the world. In order to market CellCept in China,
Roche needed regulatory approval that would only be given after the completion of drug
trials in China. Requirements included documenting the optimal drug dosage and
checking for ethnic or constitutional differences in Chinese patients.

Criticism levied against Roche centered upon organ sourcing problems in China. In most
countries, free and informed consent must be given by donors in order for their organs to
be used. In China, however, the circumstances of organ removal were often unknown or
unknowable. Critics argued that Roche, by participating in the organ transplant market in
China, was party to a corrupt system that violated the consent rights of prisoners and
other vulnerable donor populations. These critics claimed that Roche should use its power
to enforce “a much clearer position on the origin of transplanted organs.” Even though
Roche admitted that some percentage of its operations used organs taken without
consent, the company countered by claiming that it did not have the capability to discover
the origin of transplants. Furthermore, Roche explained that it was not directly involved in
the harvesting of organs. If Roche were able to test and market CellCept in China, many
thousands of organ transplant patients would have better post-operative recoveries.

The ethical question at hand can be framed as the following: Is it morally acceptable to
conduct drug trials involving the organs of donors whose consent may have been violated,
given that drug approval will benefit many thousands of patients? We can reasonably
claim that violations of consent are unethical because forced organ donation in an
environment of high demand can lead to perverse incentives. For example, a jury may
feel more justified in convicting criminals if members of that jury believe the criminals’
organs will be used to save innocent lives – regardless of the actual guilt or innocence of
each individual under sentencing. Given the information presented, the number of parties
adversely affected by this behavior is likely to be great. As the case study makes clear, a
black market in organs exists in China, and in general black markets lead to the
exploitation of vulnerable populations.

Allowing drug trials to continue in this environment is likely to strengthen the black market,
just as additional demand for a commodity like corn might lead to more suppliers entering
the corn market. Conversely, given that organ transplants occur regardless of CellCept,
the drug could have a moderating effect on the black market: successful use of the drug
would increase patients’ acceptance of organs, reducing the overall number of operations
necessary to help the same number of patients and thus reducing the demand for organs
on the black market. Since we do not have direct evidence to confirm this result, we
cannot assume it holds in our ethical analysis; but we can argue that confirmation of this
theory would significantly impact the results of Roche’s decision.

For now we will assume that the testing of CellCept would lead to violations of consent
and reinforce perverse incentives. The full ethical question must also address the tradeoff
of many possible direct benefits to continuing CellCept trials in China. As Roche makes
clear, “CellCept was a medicine which had saved and continued to save thousands of
patients’ lives by preventing post-transplant organ rejection.” If CellCept can receive
regulatory approval in China then it could improve the lives of many people, as well as
save them from other costly or less effective alternatives.

In order to properly conduct an ethical analysis of this case study, each relevant party
must be distinctly identified. The primary decision maker, the pharmaceutical company
Roche, holds an interest in the revenues it would receive from regulatory approval. While
it is easy to assume that businesses are driven solely by the profit motive, the company
spokesperson’s statement, “Withdrawing [CellCept] from the market in any country would
be morally unthinkable”, indicates that Roche may be legitimately interested in the welfare
of its end users. The party most impacted by Roche’s decision is medical patients waiting
for organ transplants in China. This party is actually made up of two categories: those
patients who will participate in Roche drug trials, and those who would receive the drug
CellCept only in the event of Chinese regulatory approval. We can assume both of these
groups belong to the same patient party for the following reasons. First, Roche has
indicated that independent institutions conduct organ procurement, and we have been
given no information to indicate that procurement procedures are different for test patients
as opposed to post-approval patients. Second, CellCept has received regulatory approval
and been placed on the market in many other countries, and testing in China is mostly
oriented towards ethnic factors.

Given that the drug has already been approved elsewhere, we can reasonably conclude
that it is likely to be adopted in China after the completion of testing. Thus, both test
patients and post-approval patients are likely to be recipients of CellCept. In the event
that either of these assumptions do not hold true, it is unlikely that classification of patients
as two separate parties would significantly affect an ethical analysis. The third and last
major party in this ethical case is the group of current and potential organ donors in China.
This group is not homogeneous, and it can be categorized across several different
dimensions. For example, the pool of organ donors in China consists of deceased donors,
future deceased donors, and living donors. Alternately, the group can be categorized by
level of consent. Some organ donors’ consent has been violated, such as certain
prisoners. Others legitimately consented to organ donation, for example individuals who
volunteered to donate organs to family members.

If CellCept were approved, consenting living donors would be more likely to experience
happiness at seeing successful transplantation of their organs to loved ones. Contained
within the donor party are also donors who are indirectly affected by Roche’s decision,
but who are directly affected by policies in China related to consent and sourcing laws. If
violations of consent are institutionalized, then Roche’s actions serve to legitimatize and
reinforce Chinese policies. Barring a longer discussion outside the scope of this paper,
we must assume that the trial and acceptance of CellCept would have a net negative
effect on the donor party. Finally, we must briefly distinguish minor parties to Roche’s
ethical decision. These parties include Roche employees and shareholders, relatives of
organ recipients, relatives of organ donors, institutions that handle the sourcing and
transplantation of organs, Chinese regulatory authorities, and Chinese policymakers.
Each of these minor parties is unlikely to change the analysis, but will be affected by
Roche’s decision.

We must use major ethical theories to develop a course of action since the morally correct
solution to Roche’s dilemma is not immediately evident. Applied here are utilitarianism,
rights, justice, caring, and virtue theories. In general, the first three theories are
constructed in order to de-center decision makers and allow for an objective appraisal of
a situation. Caring theory argues that ethics must be cognizant of the relationships that
exist between individuals, especially those characterized by vulnerability or dependency.
Virtue theory examines the effect of a particular decision on the habits and nature of a
decision maker. Application of each theory will lead to a more dynamic perspective of the
Roche drug case and will help us reach a conclusion as to whether or not Roche should
continue to test CellCept in China.

Utilitarianism
One of the most intuitive ethical philosophies is utilitarianism, through which we define an
action or policy as moral so long as it provides the greatest amount of good for the
greatest number of people given all alternative actions that could have been performed.
Utilitarianism focuses on the results of an action, and places very little emphasis on any
given party’s reason for acting. In theory, a utilitarian analysis is easy to perform and
requires three steps. First, we must define all possible courses of action regarding a
particular ethical dilemma. Second, the costs and benefits for all affected parties must be
tallied for each of the possible courses of action outlined in the first step. Third, the agent
must choose the course of action that provides the best net result, leading to the greatest
benefits net of costs.

Although useful for many large-scale ethical problems, utilitarianism has several
drawbacks. Measurement problems can arise during the second step of a utilitarian
analysis given that not all costs and benefits are easily compared or quantifiable. For
example, in cases regarding public safety, like when addressing laws that require
individuals to stop at railroad crossings, it is difficult to measure the value of a human life
or to sum the utility lost to those who are inconvenienced by a policy. Utilitarianism also
does poorly with regards to rights or justice problems. So long as an action provides the
greatest net benefits, a pure utilitarian analysis might lead us to accept the murder of an
individual (disrespecting their right to life), or to ignore unfair costs borne by a subset of
the population (resulting in an unfair distribution of costs and benefits within society, a
justice problem). One final relevant issue is our inherent inability to predict costs and
benefits to be borne far in the future. Although more problems exist, mindfulness of these
major drawbacks is necessary for a utilitarian analysis.
Proponents of utilitarianism have tried to provide solutions to the criticisms levied against
it. One of the most applicable heuristics has been the attempt to quantify measurements
in dollar terms in order to create a constant unit for the comparison of utility. This is not a
complete solution to the measurement problem given that different parties would disagree
as to the dollar value of certain costs and benefits: family members might not be willing
to trade the loss of a father or husband for any amount of monetary compensation, for
example. Another response is to acknowledge the difference between intrinsic and
instrumental goods. An intrinsic good is a good whose value is derived from the good
itself, whereas an instrumental good’s value is a function of the value it can provide
through secondary means. For example, many humans would believe that life and
personal freedom are both intrinsic goods.

Money, on the other hand, is generally seen as an instrumental good because it is

valuable only insofar as it can be used to fulfill other human needs. When comparing
between two or more intrinsic goods, however, utilitarianism provides very few guidelines
as to how we can prioritize costs and benefits. Although these responses do not fully
address the underlying issues of utilitarianism, they show how utilitarianism can remain a
useful, if not perfect, ethical ideology. When conducting a utilitarian analysis, the agent
must attempt to choose the best solution given all available information.

In completing a utilitarian analysis of Roche’s policy, we must begin by outlining all of the
available courses of action. The ethical question underpinning the case study, as posed
in the introduction, provides a useful starting point: Is it morally acceptable to conduct
drug trials involving the organs of donors whose consent may have been violated, given
that drug approval will benefit many thousands of patients? Roche has two primary
courses of action; the company can either continue CellCept testing and marketing in
China, or it can stop testing so that it does not inadvertently participate in violations of
donor consent. Other alternatives include Roche exerting pressure on the Chinese
government to improve the process of organ donation procurement, or Roche conducting
its own organ sourcing directly. Many more possible courses of action could be proposed,
but given scope constraints in this paper we will focus on the first two presented: continue
CellCept testing in China, or cease testing and divest from the Chinese market.
Each of the costs and benefits for all affected parties must now be tallied for Roche’s
possible courses of action. We will focus on Roche, CellCept patients, and Chinese organ
donors given the analysis provided in the introduction. While other minor parties will be
affected by Roche’s decision, it is unlikely that their costs or benefits will significantly
change the outcome of a utilitarian analysis.

For the first course of action, Roche would choose to continue testing and marketing
CellCept in China. No data is provided in the case document to indicate the size of
CellCept’s impact on Roche’s current or future income, but we can assume that the drug
would materially impact Roche’s income statement given that organ transplants are costly
and specialized, and the size of the potential Chinese market is large. For CellCept
patients this decision is unambiguously positive, the pool of patients is large, and the
benefits are great given that they include improved chances at living a healthy life. As
mentioned in the introduction, the effect of CellCept research on organ donors is
ambiguous.

For the most part, we concluded that CellCept would encourage questionable organ
sourcing in China and thus support a system that violates donor consent and harms
donors. Given that CellCept would only directly cause organ transplantation to occur in
research and testing operations, but would be an indirect factor in post-approval
transplants, the pool of negatively affected donors is smaller than the pool of positively
benefitting patients. The magnitude of harm done to certain donors is much greater than
the benefits for any individual patient, but since many more patients will receive CellCept,
given our limited information we will assume that the donor costs and patient benefits
cancel out. Once we consider Roche’s profits and increased capability to invest in new
drugs, Roche’s action has net benefits.

In considering the second course of action, divesting of CellCept in China, we can treat
this alternative as the opportunity cost of foregoing the first course of action. Essentially
all of the costs and benefits of continuing testing would be reversed. For example, organ
transplant patients would suffer the costs of failed transplants rather than receive
improved chances of organ acceptance, Roche would forego income from CellCept and
may have to curtail future drug development plans, and Chinese prisoners might suffer
less due to less demand for organs on the black market.
Reaching a solution for Roche’s dilemma is difficult under a utilitarian analysis given the
measurement problem. We can somewhat overcome this problem by using relative net
benefits for each alternative. Given that the first option results in opposite costs and
benefits as compared to the second option, and given that we concluded the first option
has positive net benefits, we know that the second option should have net costs. Thus,
under a utilitarian analysis, we can conclude that Roche should pursue its first option and
continue to market CellCept in China.

Rights
Writing during the 18th century, Immanuel Kant defined a basis for moral rights predicated
upon the belief that each person holds rights by the very virtue of being a human. This
foundation of Kantian Rights is called the categorical imperative. In general, the
categorical imperative holds that each person has a right to be treated as an autonomous
equal being, and each person has a correlative duty to respect and nurture the autonomy
of others. Kant specifically defines autonomy as self-law, or the ability to control our
impulses and desires. As we develop willpower and free ourselves from desire, we
become free to pursue meaningful goals in life. Given that Kant’s perspective focuses on
the individual and his or her internal motivations, any Kantian analysis depends upon
each party’s reason for action and how that reason respects or restricts autonomy.

In order to further explain the concept of a categorical imperative and provide guidance
for ethical action, Kant lists two formations of his categorical imperative. The first
formulation of the categorical imperative (CI-1) states that “I ought never to act except in
such a way that I can also will that my maxim should become a universal law” (78). A
maxim is simply someone’s reason for acting. CI-1 indicates that each action must pass
two tests: universalizability and reversibility. An action is morally wrong if an agent’s
reasons for acting are not reasons that everyone could use in principle (universalizability),
or if the agent would not be willing to have others use that reason against themselves in
the same situation (reversibility). This categorical imperative de-centers decision making
so that they do not solely focus on themselves when making ethical decisions. The
second formulation of the categorical imperative (CI-2) states that each person must “act
in such a way that you always treat humanity, whether in your own person or in the person
of any other, never simply as a means, but always at the same time as an end” (80).
Once again, Kant returns to the idea of the individual and his or her rights, and reminds
us that we must recognize the intrinsic value of other human beings. The reasoning
inherent in CI-2 does not condemn the use of others as a means to our own end so long
as we also respect and develop their autonomy. An action is morally acceptable from a
Kantian perspective if it does not violate the first or the second categorical imperatives. A
Kantian analysis on this case study requires that we come up with a maxim that Roche
would reasonably act by. In deciding to continue CellCept testing in China, Roche might
claim that, “It is always and everywhere okay to participate in a system that violates
human rights if our business will profit, if we are powerless to encourage greater
accountability, and if our operations benefit end users of our product.” This is a fairly
complex maxim, but its elements are evident from statements made by Roche in the case.

Roche is aware that its operations involve the organs of donors whose declarations of
consent are questionable, and that Chinese practices involve human rights violations
against prisoners whose organs are harvested. Without a doubt, testing and marketing of
CellCept in China will improve Roche’s profits. Roche has shown that it believes it is
powerless because, according to its company spokesman, “in all countries, independent
institutions handled organ procurement and donor information was confidential. Roche
had no way of directly influencing this process.” Furthermore, Roche has made
statements indicating that it genuinely believes in continuing the testing of CellCept for
the sake of its patients.

In order to test Roche’s decision against the first formulation of the categorical imperative,
the results of its maxim must be universalized and reversed. For the most part, Roche’s
maxim passes both of these criteria. Although we are generally uncomfortable with
businesses participating in systems that violate human rights, we can only claim that they
have moral culpability if those businesses have the capability to change the system in
which they are working. The weakness to this argument is that Roche may in fact be able
to create change within Chinese policies despite their current belief that they are
powerless. But Kant’s first formulation of the categorical imperative refers to an
individual’s reason for acting rather than what could be done, thus Roche’s maxim passes
the universalizability criterion. In regards to reversibility, employees and managers of
Roche would probably not want their consent to be violated. But given the immediacy of
human rights violations they would face in the position of Chinese prisoners or other
forced organ donors, the actions of a drug company participating in the Chinese
transplant market, when that company cannot change the treatment of Chinese prisoners,
probably not be a primary concern. Given that Roche is not directly perpetrating ethical
rights violations, its maxim would also be reversible.

Kant’s second categorical imperative, to treat humanity “never simply as a means, but
always at the same time as an end” (80), must be applied to Roche’s treatment of both
patients and organ donors. It is fairly clear that Roche is treating its organ transplant
patients as an intrinsically valuable end because the company released a statement
claiming it would be morally unjustifiable to deny CellCept to the Chinese market when it
could be used to save lives and diminish harmful outcomes. With regards to organ donors,
there is some evidence to indicate that Roche is treating them only as a means but not
as an end. Even though Roche is not directly violating the rights of organ donors, it is also
not making a reasonable effort to change consent or accountability practices in China.
Insofar as Roche is not developing the autonomy of organ transplant donors in China, it
is violating the second formulation of the categorical imperative. Even though Roche
passes the first categorical imperative, its violation of the second categorical imperative
is enough to indicate that Roche is acting unethically under a Kantian analysis.

Justice
While justice is informally defined as simply the end output of the prevailing judicial
system, justice is really the fair distribution of benefits and burdens within society. Many
individual theories have been advanced to explain what constitutes fair distribution, but
one of the more useful unifying theories comes from John Rawls. Rawls, conducting a
thought experiment, imagines what rules everyone would agree to live by if we didn’t yet
know how or where in society we would be placed. Taken for granted is the assumption
that inequality will exist in life. If everyone was subject to the original position where we
all could agree on the rules before life and society begins, but each was prohibited by a
veil of ignorance so that each individual could not determine where they would end up in
society after life began, Rawls argues that society would choose just rules so that benefits
and burdens would be fairly distributed.

The combined effects of the original position and veil of ignorance serve to de-center
ethical reasoning so that individuals do not choose rules of distribution that benefit
themselves unfairly. Through this thought experiment Rawls predicts the following
principles would lead to just distribution of benefits and burdens in society (96): 1. Each
person has an equal right to the most extensive basic liberties compatible with similar
liberties for all (The Principle of Equal Liberty) 2. Social and economic inequalities are
arranged so that they are both… a. To the greatest benefit of the least advantaged
persons (Difference Principle), and b. Attached to offices and positions open to all under
conditions of fair equality of opportunity (Principle of Fair Equality of Opportunity)

All three principles combined serve to respect the inherent rights of individuals, protect
our upside potential in life given different societal starting points, and protect us from the
downside risks of being born into a worse position or suffering misfortune. Given a conflict
between these principles, Rawls argues that the principle of equal liberty must be
respected first, followed by the principle of fair equality of opportunity, and that the
difference principle comes last. Under justice theory as proposed by Rawls, an action is
moral if it upholds all three principles.

Given the case study, we can apply a Rawlsian analysis to Roche’s decision to continue
marketing CellCept in China. If marketing the drug violates the three principles, then it is
unethical. Furthermore, if not marketing the drug violates any of the three principles, then
it could be considered unethical as well. In order to choose the best course of action, we
must then prioritize the principle violations.

For Roche’s decision to test CellCept in China, we can very quickly show that it is
unethical under Rawls justice theory. According to the information presented in the case,
“A large number of China’s prisoners were political dissidents or those who had been
jailed… not because they had violated the law or inflicted harm on others,” and also “many
of the hundreds of thousands of [members of persecuted groups] has been killed for their
organs which were then sold or given to transplant candidates.” Given that Roche’s drug
trials directly cause transplantation operations using organs taken from prisoners without
their consent, Roche participates in a system that violates the Principle of Equal Liberty:
Infringements upon freedom of speech and conscience, and infringements upon freedom
from arbitrary arrest are being made. Regarding the Difference Principle, potential organ
transplant patients and forced organ donors are both in disadvantaged positions. The
condition of both parties results in suffering and death.
Roche’s policy would transfer suffering from one party to another, causing unfair harm to
one of the least advantaged parties, thus violating the Difference Principle. A weak case
could be made that Roche’s policy supports the Principle of Fair Equality of Opportunity,
since CellCept provides a greater opportunity for organ donation patients to recover and
pursue their life goals. This case is weak because it refers to a different definition of
opportunity than is used in Rawls’ original formulation of the principles. Rawls’ use of
“opportunity” referred to a person’s ability to enter into offices and positions available
within society. The use of “opportunity” in evaluating Roche’s decision references a
broader meaning of the word. Regardless, the policy of testing and marketing CellCept in
China is unethical under a justice analysis because it violates the Principle of Equal
Liberty and the Difference Principle.

Although we have established that testing CellCept in China would be unethical under a
justice analysis, it would be worthwhile to check the ethicality of not testing CellCept in
China as well. At best, Roche would not be violating the Principle of Equal Liberty or the
Difference Principle because it would not be actively involved in policies that violate rights
and disadvantage non-consenting organ donors. By choosing not to test CellCept in
China, Roche would violate the Principle of Fair Equality of Opportunity because it would
weaken the ability of many organ transplantation patients to recover and pursue their life
objectives.

Overall, Roche’s decision to test and market CellCept in China is unethical under a
Rawlsian justice analysis. As we have shown, the decision to test and the decision not to
test violate one or more of Rawls’ principles. Since testing CellCept violates the Principle
of Equal Liberty and the Difference Principle, whereas not testing violates the Principle of
Fair Equality of Opportunity, choosing to test and market CellCept in China is the worse
alternative.

Caring
While utilitarianism, rights, and justice ethics attempt to de-center decision making by
moral agents, caring theory claims that ethics must be partial to the relationships between
members of society. An ethics based on care recognizes that each person develops as
part of a particular community and does not exist as a truly independent agent. One mode
of acting ethically, then, is to recognize and nurture the relationships that are fundamental
to living in community. Such fundamental relationships, for example, would include those
between close friends and family. While we should be partial in our ethical decision-
making, we should remain mindful of the special relationships that are held by others but
not necessarily by ourselves.

It would be selfish for an agent to presume that he or she could act in a way that dissolves
families in other countries simply because the agent is not personally involved in those
families. Given that each individual maintains so many relationships, some guidance is
necessary when choosing between conflicting responsibilities. Obviously a close
relationship, such as one between a mother and daughter, might be more important than
a distant relationship, such as between a mother and her rarely seen distant cousin. But
more importantly, we must pay special attention to those individuals who are vulnerable
and dependent upon the care that we provide. Especially in instances when vulnerabilities
and dependencies are created as direct results of a chosen action, proponents of caring
theory would claim that we have a responsibility to care for the disadvantaged parties.

In a caring analysis of Roche’s decision to test and market CellCept in China, there are
many relationships characterized by vulnerabilities and dependencies. Most relevant to
Roche is its relationship with the party of current and potential organ transplant patients.
Through its statements, Roche has clearly expressed its commitment to this party. These
patients are vulnerable to, and dependent upon, Roche’s decision because many of them
might have unsuccessful transplants if they are not allowed access to the drug.
Furthermore, the suffering and death of potential patients adversely affects close
relationships with their families. On the other hand, Roche is indirectly connected to non-
consenting organ donors who are vulnerable to the company’s decision. The relationship
between Roche and organ donors is similar to the relationship between the South African
diamond producer De Beers and victims of conflict diamond production (86).

Although De Beers does not directly order violence to be done to diamond victims, its
demand for diamonds indirectly causes violence to be done to many thousands of people
who live in countries where their safety is not guaranteed. Such violence also damages
societal and familial relationships in those countries. Likewise, by participating in the
organ transplant market in China, Roche participates in a system that harms individuals
and relationships. Roche differs from De Beers because the use of CellCept does not
create direct demand for organ transplants. Transplant procedures are likely to occur
regardless of the availability of CellCept, and the drug only improves the possibility that
the operation will be successful.

Under a caring analysis, Roche should continue to test and market CellCept in China.
Given that Roche’s decision directly impacts organ transplant patients, and the company
has a stated commitment to this party, Roche should do what it can to keep CellCept on
the market. Furthermore, Roche’s decision only partly influences organ donors, and thus
Roche should not hold itself fully accountable for their suffering. Based on the logic behind
caring theories, however, Roche should make a reasonable attempt to change Chinese
policies to protect vulnerable organ donors.

Virtue
Instead of focusing on the reasons or the results of an action, virtue in ethics emphasizes
the nature of the agent making an ethical decision. According to Edmund L. Pincoffs,
virtues are dispositions “to act, feel, and think in certain ways that we use as the basis for
choosing between persons or between potential future selves” (111). In other words,
virtues are socially desired, cultivated habits that we find useful for living in communities.
Virtues vary in terms of how easy or difficult they are to learn. Furthermore, virtues are
expressed by the actions we choose to take. For example, a person who thinks carefully
before acting exhibits the virtue of prudence. A person who consistently chooses to think
and rationalize decisions before acting has developed prudence as a virtue, and in some
sense can be called virtuous. An action is morally acceptable if it exhibits, reinforces, or
exemplifies virtue. Virtue ethics, while providing very few specific guidelines regarding
how to act morally, are very useful for making everyday ethical decisions.

Although certain habits may be virtues or vices depending upon the particular decision or
societal context, oftentimes individuals can easily identify virtue when they see it. Virtue
ethics also appear to be similar to the ethics of caring, since both stress the role of society
and relationships, but virtue differs insofar as morality hinges upon the way in which
actions shape the agent. The importance of making a perfect decision is less important
than making good decisions consistently. If each member in society strives to be more
virtuous, then that society will be better to live in than one in which virtue is not practiced.
By choosing to remain in China and test CellCept, Roche exhibits the virtue of caring.
Roche cares for the well being of others by following through on its stated commitment to
organ transplant patients. Roche’s willingness to tolerate different cultural norms,
however, may reinforce callousness (a vice) on the part of those who judge and sentence
Chinese prisoners.

Alternately, Roche might deem the current policy of testing CellCept in China to be
unethical and would divest from China. Doing so would exhibit the virtue of
conscientiousness, or the willingness to take action against perceived ethical breaches.
Such an action would hopefully lead China, or other countries, to reconsider the nature
of their policies on organ donation.

Virtue theory is difficult to apply to this particular case study because the most virtuous
course of action is not easily identified. Furthermore, Roche’s actions could exhibit many
different virtues or vices depending on the perspective of an outside observer. Overall,
leaving the Chinese market in order to make a statement against current organ donation
policies appears to be the most virtuous action because doing so encourages better
policies in China and shows the virtue of benevolence.

Conclusion
Personally I am greatly conflicted on Roche’s dilemma in China, but I do feel that the
company should continue it’s testing and marketing of CellCept. My own approval or
condemnation of Roche’s actions is contingent upon the degree of influence CellCept has
in determining the treatment of Chinese prisoners and other unwilling organ donors. The
case study does not present enough information to definitively show how much CellCept
trials cause the suffering of organ donors. It is clear that human rights violations would
continue to occur if Roche divested from China. Given that CellCept is a post-
transplantation drug, I do not believe that Roche is a cause of suffering for the
disadvantaged donor group.

In reaching my conclusion, I found both the rights and caring theories to be very helpful.
I feel that an analysis based on Kant was the most illuminating because it forced me to
be nuanced in my analysis without being stymied by the ambiguities inherent in the case.
While the rights analysis actually concluded that Roche is acting unethically by continuing
its trials of CellCept, I personally think that the violation of the second categorical
imperative can be remedied by an alternative course of action. If Roche chooses to
continue operating in China, but also attempts to enact long-term change from within the
very system in which it is operating, then Roche could hopefully improve the rights of
Chinese prisoners and other donors. My caring analysis, which concluded that Roche is
justified in continuing its operations, also suggested this additional action as a way to
remedy the harm borne by unwilling donors.

Utilitarianism, justice, and virtue were less helpful in analyzing the Roche case. A justice
framework is useful to recognize that severe liberty violations are occurring in China, but
the other elements of Rawls’ theory were difficult to evaluate due to a lack of hard
information. Utilitarianism suffered from the same problem: there simply was not enough
information to conclude the scope or magnitude of costs and benefits for all parties. Virtue
theory was the least helpful ethical theory in this case study because both courses of
action can be virtuous depending upon how they are presented.

QUESTION 1 Explain how utilitarianism might provide a defense for Roche and how a rights - based ethic
might instead condemn Roche’s drug trials in China. Which of these two approaches is stronger or more
reasonable? Explain the reasons for your answer. ANSWER Utilitarianism is a general term for the view that
action and policies should be evaluated on the basis of the benefits and cost they produce for everyone in
society. Specifically, utilitarianism holds that morally right course of action in any situation is the one that,
when compared to all other possible actions, will produce the greatest balance of benefits over costs for
everyone affected. The inclusive term used to refer to the net benefits of any sort produced by an action is
utility. Hence, the term utilitarianism is used for any theory that advocates selection of that action or policy
that maximize utility. i. Might provide a defense for Roche by stating that the organs taken from the prisoners
with their consent for the purpose of Roche’s drug trials is acceptable because of: A utilitarian would argue
that Roche was respecting the Chinese laws by first testing the drugs on Chinese patients. One could argue that
prohibiting the research that Roche was performing could inhibit future Chinese patients from receiving a drug
that could be necessary to sustain life. Roche’s CellCept had a beneficial plan for the Chinese society in
creating a drug to help sustain life for their specific ethnicity. As a utilitarian, finding a resolution for the
greater good is the most ethical and just decision. The utilitarian might argue that Roche had no control over
how the organs were harvested. Knowing or not knowing where the organs were originating from wouldn’t be
as important, as long as their end goal of saving lives would be completed. ii. Might instead condemn Roche’s
drug trials in China because of: Rights are defined as an individual entitlement to freedom of choice and well-
being. This may lead a rights based ethic to say that the prisoners from which the organs were being harvested
could not be consenting because they were being held against their free will. An ethic may also argue that there
is no way to know under what conditions the organs were being removed from such executed prisoners.
However since ‘rights’ are up to the individual, it cannot be determined if the individual is deceased. The
conditions of this study are questionable since there is no way of knowing if the prisoner would have
volunteered or declined to be a part of this study. More so, if the organs are being sold for a monetary profit
instead of research, then this decision would be defined unethical by moral standard.

ROCHE • A pharmaceutical company. • Developed the drug called CellCept. • Ambitious goal to reduce
energy consumption and greenhouse gas emissions. • Testing CellCept in China.

TRAIDOS BANK • Small British Financial Institution. • Ethical bank which offers saving accounts and
investments. • Pride itself on being "the world's leading ethical and sustainable bank". • Decision making
guided by 6 principles. • Offer 13 funds in which individuals could invest their money.

THE ISSUES • Doing transplant illegally. • Take out organs from their body without their consents. • Selling
and buying organs in black market is also an unethical action. • People imprisoned and then executed them for
their organs against their will. • Harvested organs of human body.

Explain how utilitarianism might provide a defense for Roche and how a rights-based ethic might instead
condemn Roche’s drug trials in China. • Utilitarianism is defined as “… a view that holds that actions and
policies should be evaluated on the basis of the benefits and costs they will impose on society.” • A utilitarian
would argue that Roche was respecting the Chinese laws by first testing the drugs on Chinese patients. One
could argue that prohibiting the research that Roche was performing could inhibit future Chinese patients from
receiving a drug that could be necessary to sustain life. • Roche’s CellCept had a beneficial plan for the
Chinese society in creating a drug to help sustain life for their specific ethnicity. As a utilitarian, finding a
resolution for the greater good is the most ethical and just decision. T • he utilitarian might argue that Roche
had no control over how the organs were harvested. Knowing or not knowing where the organs were
originating from wouldn’t be as important, as long as their end goal of saving lives would be completed.

1. Explain how utilitarianism might provide a defense for Roche and how a rights-based ethic might
instead condemn Roche's drug trials in China. Which of these two approaches is stronger or more
reasonable? Explain the reasons for your answers.
2. Is it ethical for Roche to continue testing CellCept on its Chinese transplant patients? Explain in
detail
 3. Is Traidos Bank ethically justified in excluding Roche's stock from the funds it offers its
customers? Consider your answer in light of the bank's duty to invest money wisely and in light of
its own conclusion that Roche was among "the best performing 50% of pharmaceutical companies
in Europe," was "transparent about sustainability issues," had "a comprehensive position
regarding genetic engineering and clear ethic guidelines for clinical trials," enforced
high"standards" for its suppliers, and strove to "reduce energy consumption and greenhouse gas
emissions." Explain in detail.

4. Explain how utilitarianism might provide a defense for Roche and how a rights-based ethic might
instead condemn Roche’s drug trials in China. Which of these two approaches is stronger or more
reasonable? Explain the reasons for your answer. Explain how utilitarianism might provide a defense
for Roche and how a rights-based ethic might instead condemn Roche’s drug trials in China. Which of
these two approaches is stronger or more reasonable? Explain the reasons for your answer.
Utilitarianism is an approach to business and “moral-decision making” (p.76) that “the course of
action would have the most beneficial consequences and the fewest harms” (p.76). Using this
approach one might argue that Roche was being very conscientious by testing their drug on Chinese
patients who would otherwise not be able to receive the potentially life-saving antirejection
medication since China does not allow drugs that have not been tested on actual Chinese patients to be
sold in their country. On the other hand, the rights based ethic approach would argue that “up to 90%
of all transplanted organs in China come from executed prisoners” (p.143) and they most likely did
not give consent or did so under some sort of duress.

Answer 1: Utilitarianism is as a view that holds that actions and policies should be evaluated on the basis of
the benefits and costs they will impose on society. A utilitarian would argue that Roche was respecting the
Chinese laws by first testing the drugs on Chinese patients. One could argue that prohibiting the research
that Roche was performing could inhibit future Chinese patients from receiving a drug that could be
necessary to sustain life. Roche’s Cell Cept had a beneficial…show more content… Lives are on the line in
both situations. Views differ from person to person and different arguments can be made for both
utilitarianism and rights-based. When it comes to the right-based ethic, Roche was in violation of the
prisoner’s basic human rights. The company knew that up to ninety percent of organs came from executed
prisoners. The company should have looked into why the prisoner was executed because some of the them
were there because of their religious belief and the different opinions between them and the governments.
One view is that of the rights based ethic. A utilitarian measures utility of the benefits produced by an
action. Ethics could prove that many prisoners being held were not criminals. They could also prove that
many organs were being harvested only for money.
1. Traidos Bank Roche CellCept Summary
2. 2.  A small British financial institution.  Ethical bank which offers saving accounts and
investment.  “The world’s leading ethical and sustainable bank.”  Decision making
was guided by six principles
3. 3.  A pharmaceutical company.  Met bank’s ethical criteria and so qualified for
including its stock in the bank’s portfolio of investments in year 2009.  Using systems
to monitor and enforce social standards in its supply chains.  Reduce energy
consumption and greenhouse gas emissions.  Received the Public Eye Award that is
sponsored by the Berne Declaration and Greenpeace in January, 2010.  Testing
CellCept in China.
4. 4.  A drug that prevents a patient’s immune system from rejecting an organ that has
been transplanted into the patient.
5. 5.  In 2009, Traidos Bank had determined that Roche had met the banks ethical criteria
and qualified for including its stocks in the banks portfolio  On September 23, 2010,
Traidos Bank announced that they had removed Roche from is investment Portfoilio 
Several months later the bank found out about Roches Research programs in China
6. 6.  A large part of transplanted organs in China originate from executed prisoners 
Roche does not verify the origins of the organs in its China based trials  After further
investigations, the bank decided Roche no longer met its ethical criteria  Roche was
testing the drug Cell-Cept on Chinese transplant patients because Chinese law requires
that any drug sold in China must first be tested on Chinese patients
7. 7.  Up to 90% of transplanted organs in China come from executed prisoner  Roche
was concerned by the growing controversy over its participation in transplant operations
that in many cases, the company had to use organs taken from prisoners with out their
consent, or forced out of thems  Dr Schwan stated that Cell-Cept was a medicine which
had saved and continued to save thousands f patients lives by preventing post transplant
organ rejection
8. 8.  Not only were the organs of deceased people sold covertly to doctors, hospitals, but
living donors also secretly sold their organs by using easily forged documents testifying
that they were related  A large number of the prisoners were political dissidents or those
who were jailed because of their religious or political beliefs  In 2010, human rights
groups announced that their investigations had uncovered evidence that more than 9000
members of Falon Gong had been executed in Chinese Prisons
9. 9.  Doing a transplant illegally  Take out organs from someone body without their
consents  Selling and buying organs in black market is also an unethical action to do 
Forging documents to sell organs  People imprisoned and then executed them for their
organs against their will  Harvested organ of the human body
10. 10.  Explain how utilitarianism might provide a defense for Roche and how a rights-
based ethics might instead condemn Roche’s drug trails in China. Which of these two
approaches is stronger or more reasonable? Explain the reasons for your answer.
11. 11. Utilitarianism might provide a defense for Roche by Stating that the organs taken
from the prisoners with their consent or without their consent for the purpose of Roche’s
drug trials is acceptable. Although it was an unethical behavior, but it might bring a lot of
benefits to the transplant patients in China once the drug test success.
12. 12. Human rights every human has rights in doing everything without the force of
anyone. Prisoner rights Although the prisoner has given a permission in an agreement to
do something, such consent while imprisoned cannot consider free will
13. 13.  Is it ethical for Roche to continue testing CellCept on its Chinese transplant patients
?
14. 14. Utilitarian concept: According to utilitarian concept it is ethical for Roche to continue
testing CellCept on its Chinese transplant patients. Moral right or human right judgement:
Based on moral right judgement, it is unethical for Roche to continue testing CellCept on
its Chinese transplant patients.
15. 15.  Is Traidos Bank ethically justified in excluding Roche’s stock from the funds it
offers its customers? Consider your answer in light of the bank’s duty to invest money
wisely and in light of its own conclusion that Roche was among “the best performing
50% of pharmaceutical companies in Europe,” was “transparent about sustainability
issues,” had a comprehensive position regarding genetic engineering and clear ethical
guidelines for clinical trials,” enforced high “standards” for its suppliers, and strove to
“reduce energy consumption and green-house gas emission.”
16. 16. If Traidos Bank’s duty is to invest money wisely, then it is unethical to excluding
Roche’s stock from their investment portfolio. - Return of Investment (ROI) will be
lower. - Nowadays, society is more concern on health. Since, based on Traidos Bank own
conclusion towards Roche pharmaceutical giant, it is unethical for the bank to excluding
Roche’s stock. - To prevent economic recession and apply work opportunity - Society
welfare , contamination reduce - Encourage society to engage in organ donation
17. 17.  Are Traidos bank’s ethical standards set too high?
18. 18. Ethical standards of organization not too high, set on general Sometimes need
toleration, based on type of funded organizations
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