The unethical use of ethical rhetoric: the case of flibanserin and pharmacologisation of female sexual desire.

The current debate around sexual dysfunctions focuses mostly on the pharmacological regulation of lowered sexual desire in women. The Food and Drug Administration approval of the first drug-Addyi-to treat this condition was preceded by a campaign, in which ethically saturated arguments were used to lobby policy makers. This article provides a critical evaluation of these arguments. In particular, we focus our attention on deceitful and unethical use of moral arguments and concepts. First, we present the context in which hypoactive sexual desire disorder is defined as a serious medical condition, showing how non-medical and non-scientific influences shaped the understanding of the problem. Further, we demonstrate how in current discussions regarding lower sexual interest attention has been shifted from psychosocial to pharmacological solutions and we trace the ethical consequences of such a change. We argue that, in addition to typical detrimental effects of overmedicalisation, there are new serious perils. In particular, we demonstrate that it is highly probable that pharmacologisation of female desire-contrary to the emancipatory declarations of the drug proponents-exerts pressure on women and narrows the range of potential choices they can make. As a result, it is inconsistent with the very idea of free choice. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.