In the modern world of medicine, large pharmaceutical companies have often engaged in heated debate. The big pharma controversy centers around poor marketing practices used by these big pharma companies, which have had negative consequences for consumers. In James Le Fanu's book, The Rise and Fall of Modern Medicine, the existence of secrets held by pharmaceutical companies is highlighted. These secrets can be divided into four groups: (1) Pharmaceutical companies underestimate dangerous side effects for consumers, (2) Pharmaceutical companies control the information doctors receive, (3) Patients are prescribed drugs that they do not need, (3) Patients are prescribed medications that they do not need, and (4) medications target symptoms, not causes. The Big Pharma controversy encompasses these secrets, which revolve around pharmaceutical companies, government and consumers. This controversy exists between supporters of the marketing tactics used by pharmaceutical companies and critics of these tactics. These secrets held by pharmaceutical companies inevitably raise the question: Is it ethical for medical professionals to take advantage of patients? A balance between the pros and cons of the marketing tactics used by the pharmaceutical industry must be achieved if the system is to benefit everyone. To do this, it is important to consider the ethical issues related to these tactics. Many ethical dilemmas exist when examining the pharmaceutical industry's tactics. This article will serve to examine a few of these examples. Today's medical world is dominated by industry, as doctors and patients rely on pharmaceutical companies to provide medications that address patients' health concerns. Pharmaceutical companies intend to profit from the d...... middle of paper ....../147318/100,000_americans_die_each_year_from_prescription_drugs,_while_pharma_companies_get_rich>.Petersen, Melody. Our Everyday Medicines: How Pharmaceutical Companies Transformed into Clever Marketing Machines and Hooked the Nation on Prescription Drugs. New York: Farrar, Straus and Giroux, 2008. Smith, Brendan L. “Inappropriate Prescribing.” American Psychological Association. Np, June 2012. Web. December 7, 2013. .Thompson, Dennis F. “Understanding Financial Conflicts of Interest.” New England Journal of Medicine 329.8 (1993): 573-76. Ventola, CL “Direct-to-consumer pharmaceutical advertising.” Pharmacy and Therapeutics 36.10 (2011): 681-84. Wazana, Ashley. “Doctors and the pharmaceutical industry: is a gift ever just a gift?” » Obstetric and gynecological investigation 55.8 (2000): 483-84.