Benjamin Nguyen¹, Prof. Michael Müller²

^{1 Centre} for Social Ethics in Healthcare, Johann Wolfgang Goethe University

^{2 Chair} of Pharmaceutical and Medical Chemistry, University of Freiburg

Against the backdrop of the escalating biodiversity and climate crisis, the field of pharmacy is addressing the question of its own ethical responsibility for the preservation of the planet under the terms ‘green’ or ‘sustainable pharmacy’. To date, questions of temporal ethics have not been addressed in these studies, even though time and temporality are of central importance in pharmacy in numerous contexts. Pharmacokinetics (PK) and pharmacodynamics (PD) are particularly relevant in this regard. These disciplines investigate what the body does with the ingested substance (PK) and, conversely, what the substance does to the body (PD) over time. Time is invariably conceived of as a linear variable in this context – even though many biological and pharmacological processes are non-linear. This gives rise to numerous epistemological and ethical challenges – for example, risks that do not occur in a linear relationship with chronological time may be normatively over- or underestimated. This applies in particular to processes that follow an exponential trajectory. For instance, it has recently been demonstrated that various industrially produced toxic substances accumulate exponentially in foodstuffs. It is not yet possible to determine what health risks this entails for the plants, animals or humans affected.

This exponentiality as such raises numerous questions of the ethics of time, which have so far not been taken into account in sustainable pharmacy, nor in health technology assessment or One Health ethics. These include:

• How can ethical reflection take place within exponential time structures?
• Who bears responsibility for rapid intervention when exponential accumulation processes become apparent?
• Who bears responsibility for the potential occurrence of adverse health or environmental effects resulting from the exponential accumulation of toxic substances?
• How can exponential processes be taken into account in guidelines on One Health ethics or public health policy measures?

The epistemological prerequisite for answering this question is that time should no longer be regarded as a value-neutral and context-free constant in pharmacy and chemistry. Building on this, institutional, One Health and public health ethical approaches can be developed in collaboration with the fields of pharmacy and chemistry.