From: hrubin@mentor.cc.purdue.edu (Herman Rubin)
Newsgroups: sci.med
Subject: Re: Cost Concerns in Med School?
Date: 3 Oct 92 01:38:40 GMT
Organization: Purdue University Statistics Department

In article <BvIExn.A7r@wpg.com> russ@wpg.com (Russell Lawrence) writes:
>From article <BvHzHC.CnB@mentor.cc.purdue.edu>, by hrubin@pop.stat.purdue.edu (Herman Rubin):
>hr> Government regulators are responsive to demands for protection, 
>hr> and concern for the benefits of actions are way down the list.  

>Perhaps.  This problem can be remedied by reevaluating the relationship
>between risks and benefits.

That is exactly what I have been asking for.  I have no problem with an
agency such as the FDA enforcing the requirement that full information
be provided.  But I object to the final evaluation being made by such 
an agency, or even allowing such an agency to keep me from getting the
relevant information to make my decision.  The FDA currently does both
of these.

>hr> In addition, when these people feel it is their Divine purpose to 
>hr> protect people from themselves, they act as the FDA has acted.  

>The FDA wasn't created to protect people from themselves, Herman.  Its
>purpose, from day one, was to protect consumers from incompetent and/or
>unscrupulous purveyors of foods and drugs.  If you'd like to abolish
>the FDA and replace it with super-stringent labeling requirements, that's
>fine with me, but to simply abolish it, while relying on the benevolence
>of product manufacturers, wouldn't be a wise idea.

I know that.  I have never advocated not protecting consumers from
unsrupulous purveyors, and I do not know of any good ways to protect
them from incompetent ones, other than insisting that relevant information
be available.  You have seen my postings; I am not relying on the
benevolence of manufacturers, and I have no problems with coming 
down hard on dishonesty, including deception.

But there is no way to create a government agency with career members
like the FDA and have it staffed by others than those who are not very
good themselves, or they would be in the private sector, except for those
with the mission to protect people from themselves.  The FDA does not
provide much in the way of opportunities for people to advance themselves
scientifically; the setup almost forces the results.  Quis custodiet
ipsos custodies.

An honest drug company produces a product which it turns out years 
later to increase the chances of undesirable effects in people who
used the drug or their offspring, and we stupidly hold that company
liable for big bucks.  On the other hand, an FDA official keeps 
thousands or millions from a drug which will keep them alive or
healthy, and delays the drug for years, and suffers no consequences.
But if this same official, on the basis of incomplete but honest
studies, allows the drug to be used and a small number of adverse
effects are found, blooie!  Everything has risks and benefits, 
and allowing paranoiacs or people with messianic complexes to 
make decisions is the situation we are in.

The medical profession is partly to blame by not openly 
acknowledging that vast ignorance exists, and is not going 
to be greatly reduced in a few years.  Not putting the cards
on the table and letting people at least attempt to make 
decisions based on the known information is the crime.
-- 
Herman Rubin, Dept. of Statistics, Purdue Univ., West Lafayette IN47907-1399
Phone: (317)494-6054
hrubin@snap.stat.purdue.edu (Internet, bitnet)  
{purdue,pur-ee}!snap.stat!hrubin(UUCP)
Newsgroups: sci.med