I really don't like it when the government passes laws meant to protect me from myself.
Obviously out of about 6+ billion people on the planet some are gullible and some make bad decisions, but I think we should have the freedom to be stupid, dangerously stupid too as long as its only dangerous to ourselves.
Robin Hanson recently wrote about bicycle helmets versus climbing Everest. It turns out that the death rate for attempts to climb Everest is higher then the death rate from not wearing a bicycle helmet. But we have strong laws for helmets, yet anyone can attempt to climb Everest.
Not only is the government protecting people from themselves, but it hypocritically seems to prefer to regulate average folk over well of adventurers. Think about other highly dangerous fun that is expensive and perfectly legal.
This is mostly silly and a bit sad, but it has a very serious side when it comes to medical technology.
The way any technology advances is by trial and error. By taking longer to put some new treatment on the market and get large scale feedback, we accomplish two things.
1. In the short term we may well save some lives.
2. In the long term we certainly slow down progress and this costs a lot of lives.
We save a few in the short therm, to kill many in the long term.
This would be quite rational IF someone else was forcing medial experiments on us!
But when WE are willing to take the risk, the government is restricting our current freedoms, and killing our future children/grandchildren.
You think I'm overstating the case? Image if modern regulatory approval was applied to penicillin? I guarantee a lot of lives with severe penicillin allergy would have been saved. I also guarantee A LOT more people would have died before penicillin finally made it to market. Image your ancestors died due to a simple bacterial infection while penicillin was being approved.
But wait! That was just the delay in penicillin, now image that all other antibiotic progress was equally delayed, as it would be. Actually the delays compound so everything is delayed a little bit longer.
Now can you see why taking longer to approve new treatments has a such a terrible long term cost?
Counterargument: imagine if every doctor and crackpot could attempt to sell his 'medicine' to everybody. Imagine you having to pick what works from a zillion possibilities. Imagine your ancestors died because they believed some snake oil salesman.
Imagine if everybody could buy as much penicillin as they wanted. Imagine bacteria getting resistant in 1950 or so, and you getting pneumonia in 1955.
Imagine having something like this: http://en.wikipedia.org/wiki/Diethylstilbestrol#DES_daughter... being fairly frequent, and not being able to figure out what is causing it because there are just too many variables involved (the guy selling your medicine may not be able to control the dose good enough, nobody tracks interactions between medicines, etc)
"Imagine you having to pick what works from a zillion possibilities."
But this is precisely what every one of us has to do every day. That's life! Right now, I could drive in an unlimited number of directions, buy ice cream, go to a movie, climb a tree, read a book, run out of the room screaming, etc. There are an infinite number of actions available to me. Solving these kinds of problems is what your brain is for!
No thing in the universe is omniscient: not any group, individual, imaginary deity, etc. Ultimately, there is no reason to trust in anything but your own mind and senses. It's your life, and you have to choose. When people forcibly stop you from doing your own thinking and acting upon it, your life is being stifled: it's less than it could be.
imagine if every doctor and crackpot could attempt to sell his 'medicine' to everybody.
False dichotomy.
Just because we would allow something like that, does not mean there would be no testing, or no government regulated testing and labeling. If you chose you could just stick to the AAA tested stuff. I am not arguing that we ban testing. False choice!
I understand your sentiment, but imagine the process of choosing a very risky treatment. You sign a form saying "For reals, I know this may kill me, but I'm not going to sue you unless you do something crazy like jam a fork in my head during the procedure."
That should be enough, right?
But it's not. Because if things really do go badly, many patients in our sue-happy country will say "well I knew it was risky, but I didn't know HOW risky!" And the patient may win the suit - maybe justifiably, maybe not. But doctors know this and will be cautious. So that's one contraint on you getting to try whatever you want.
Secondly, say things go badly and the patient is horribly hurt but not killed. Now he/she needs expensive medical treatment every day. Is the government going to pay for that? Surely your waiver can't also waive Medicare? So the government (meaning me and my tax dollars) also have some interest in not letting you undergo any procedure you want.
If you could really, truly waive all your rights to recourse and help, maybe you could get any procedure you want. But if you could do that, wouldn't you be pressured to do so when you didn't want to?
"well I knew it was risky, but I didn't know HOW risky!"
Right, but a contract is a contract. I bet all but one of Donald Trump's ex wifes wished they could get out of the pre-nup. But as suit happy as our society is, contracts actually work.
Secondly, say things go badly and the patient is horribly hurt but not killed. Now he/she needs expensive medical treatment every day. Is the government going to pay for that?
No. Today we have medial trials on humans. Today when something horrible happens the companies take over the costs. It has always been that way, nothing new here.
You could ask, well what if the companies don't want to take on the extra costs which would result of testing drugs on humans earlier? That is perfectly fine. No one will be forced to rush to market.
If you could really, truly waive all your rights to recourse and help, maybe you could get any procedure you want. But if you could do that, wouldn't you be pressured to do so when you didn't want to?
How is this different from Do Not Resuscitate? We have that, it's legally binding, people could be pressured into signing one.
Humans are demonstrably terrible at long-term risk analysis even when given full information. Hence, helmet laws. But we are even worse when we do not have full information, and when it comes to medicine, it's often not possible for us to even be fully informed. Personally, I don't want to have to ask my doctor what kind of clinical trials a drug he's prescribing has been through. If he gives me an antibiotic, I want to know that it has been approved by the FDA.
If you have a condition that there are experimental treatments for, try to get into one of the clinical trials.
Personally, I don't want to have to ask my doctor what kind of clinical trials a drug he's prescribing has been through.
I always do that! Why don't you do it today? Do you believe doctors and the FDA a flawless? Do you care if a drug has been on the market for decades versus one that's just been approved? Do you think that matters?
I suppose this does indicate a deeper difference between the intuitive assumptions of libertarians versus more pro-centralized control people.
I've often found that people who are more pro-regulation also have a very strong faith in the goodness and wisdom of officials.
Of course I don't believe the FDA and doctors are flawless. But I trust that for something like an antibiotic that yes, they do know better than I do. Most people, myself included, don't know much about medicine. Most people, myself included, don't know much about most things. Civilization works through specialization, which means that most of the time, you will have to trust another person who has specialized in something you have not.
If the drug in question is not as pedestrian as an antibiotic, I may research it. But when I made the decision to take it, I would factor in the significant fact that the FDA had approved it. I consider this fact significant because the FDA is so strict about what drugs and procedures pass muster.
There's a probabilistic argument that I think you are skipping. Given what I know and what the FDA knows, I find it more likely that the FDA's decision on such things as what drugs are safe for what circumstances will maximize my well-being.
I am not sure what you mean? Before we did not have things like the USDA or FDA.
If we maintain that it is illegal to claim regulatory approval unless you actually have it, then that gives us a choice (between tested/approved and not) which we have not had before, and don't have now.
What we have done, is replace all lack of regulation and testing with a universal mandate for extremely long and expensive regulation and testing.
I feel like everyone is interpreting my point as a dichotomy between everything or nothing, between the situation as it is today or total anarchy. But that is not at all what I am saying.
Obviously out of about 6+ billion people on the planet some are gullible and some make bad decisions, but I think we should have the freedom to be stupid, dangerously stupid too as long as its only dangerous to ourselves.
Robin Hanson recently wrote about bicycle helmets versus climbing Everest. It turns out that the death rate for attempts to climb Everest is higher then the death rate from not wearing a bicycle helmet. But we have strong laws for helmets, yet anyone can attempt to climb Everest.
Not only is the government protecting people from themselves, but it hypocritically seems to prefer to regulate average folk over well of adventurers. Think about other highly dangerous fun that is expensive and perfectly legal.
This is mostly silly and a bit sad, but it has a very serious side when it comes to medical technology.
The way any technology advances is by trial and error. By taking longer to put some new treatment on the market and get large scale feedback, we accomplish two things.
1. In the short term we may well save some lives. 2. In the long term we certainly slow down progress and this costs a lot of lives.
We save a few in the short therm, to kill many in the long term.
This would be quite rational IF someone else was forcing medial experiments on us!
But when WE are willing to take the risk, the government is restricting our current freedoms, and killing our future children/grandchildren.
You think I'm overstating the case? Image if modern regulatory approval was applied to penicillin? I guarantee a lot of lives with severe penicillin allergy would have been saved. I also guarantee A LOT more people would have died before penicillin finally made it to market. Image your ancestors died due to a simple bacterial infection while penicillin was being approved.
But wait! That was just the delay in penicillin, now image that all other antibiotic progress was equally delayed, as it would be. Actually the delays compound so everything is delayed a little bit longer.
Now can you see why taking longer to approve new treatments has a such a terrible long term cost?