Here in the US most of those decisions have been taken out of the hands of the doctors, patients and pharmacists and put in the hands of the HMO's. Some states have passed laws forbiddin the practice, but the HMO's have powerful lobbies and work hard to keep those laws out of other states. That the practice is so blatantly unethical is how the HMO's have been defeated in the few states that have passed the law. Eventually something will be done, but if the HMO's keep fighting the socialists will win and health care matter will be decided by some underpaid, incompetent government employee with a god complex. (much like most of our airport security soon will be)