If I own something that is essential for other people to live, like medicines, and I know that I have made it impossible for them to afford it, am I responsible for their death?

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Yes you are. Your decision to deny others access to the life-savingdrug has led to their death. But how serious is your responsibilityfrom a moral point of view? That depends on the circumstances. Perhapsthe medicine was in short supply and you needed what you had for yourown survival or that of your family. In this case, I think you didnothing wrong. Or perhaps the medicine was in short supply and youchose to give it to those who could pay you the most. This way ofrationing your supply is not beyond moral criticism, but at least yourdrugs saved as many people as possible and so your conduct did notincrease the number of deaths beyond what was unavoidable.

Nowconsider drug companies in the real world. They patent their medicinesand then enjoy exclusive rights to sell them at monopoly prices, whichcan be 400 times higher than the marginal cost of production. There aregeneric producers in developing countries which produce much cheaperversions of the same drug for sale to the poor. But the largepharmaceutical companies and their governments, through treaties andlaw suits, are working very hard and quite successfully towardsuppressing the production and sale of generic versions of drugs stillunder patent. Millions are dying as a result.

The justificationoffered for such conduct is that inventor firms have a right to theirintellectual property in the invention of a new drug. If the right hereinvoked is the legal right, it won't settle the issue, which is whetherthe creation and enforcement of such legal rights is morallyjustifiable. Is there then a moral right to exclusive ownership ofintellectual property? Think about it: If you and your partner hadinvented the Tango, would it have been wrong for any of the rest of usto copy your dance without your permission? And, if you believe thereis such a moral veto right, do you think it would have the exact same20-year expiration date as is enshrined in patent law? Most defendersof patent rights would not make such extravagant claims. They wouldinstead appeal to the social utility of the patent system, whichencourages the development of new medicines. But this appeal runs afoulof the fact that the majority of humankind cannot afford drugs underpatent. By suppressing poor people's transactions with themanufacturers of cheap generic drugs, our governments andpharmaceutical companies are causing many of them to die for the sakeof gains (incentivizing drug development) that benefit only to the rich.

Mustwe then, in order give the poor access to new medicines at competitivemarket prices, take away the incentive to develop new drugs? We mustindeed take away THIS incentive: monopoly pricing powers. But we canstill incentivize drug development in other ways, for example throughan arrangement under which governments would reward inventor firms inproportion to the health impact of their invention. Under such ascheme, we taxpayers would pay some money to drug companies for any newand effective medicines they invent. But we would also benefit throughlower prices for drugs and medical insurance, because any newlyinvented drug could immediately be produced by generic manufacturers,so that its price would be just slightly above its marginal cost ofproduction.

Because such alternative schemes for incentivizingthe development of new drugs are readily available, we are indeedmorally culpable for killing millions of people in the developing worldby making existing and effective life-saving medicines unaffordable tothem.

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