[yummyfajitas]

We probably would see more dangerous drugs. We would also see more beneficial drugs, and more drugs with a mixed package of benefits and harms.

Another hypothetical: we might see an anti-depressants with a lower risk of sexual side effects, but a higher risk of heart attack. The FDA considers heart attacks much worse than impotence, so they would probably ban this drug.

Since I don't care that much about long life, but I care a great deal about good sex, I would probably choose this drug over a safer one which causes low sex drive. What right do you have to deny me this choice?

[ErrantX]

This is where my cynicism kicks in; look at the drugs companies. I suspect deregulation would see some very shady practices evolve and highly dubious drugs being pushed on hapless patients.

You clearly have the intelligence to make the decision you outline. You perhaps have the cynicism to see through marketing guff - or will take the time to read the research. Will everyone be able to make such an informed choice? Especially if the drugs companies are queued up pushing their merchandise!

What we have now limits your options, yes. But it also protects many others from a potentially dangerous uninformed decision. I believe at the moment we have the happy medium of morally protecting many people whilst still allowing an element of choice.

Here's a counter example too. Imagine you made your informed choice and then found that 5 or 6 years down the line these drugs left you with recurring, painful urinary infections. Or perhaps it causes memory loss. How would you feel about the choice you made then?

The irony is that with deregulation the chance of either of those drugs having such an effect seems potentially a lot higher....

[yummyfajitas]

So basically, you feel that there is a set of people out there incapable of making decisions for themselves. I suspect you also don't consider yourself to be part of that set.

But if some people truly are incompetent, why not just have them declared as such and not restrict the rights of others? Rather than creating a class of elites who rule over all of us, why not simply delegate the task of managing the incompetent to social workers or other such professionals?

[ErrantX]

you feel that there is a set of people out there incapable of making decisions for themselves

Not exactly what I said. I think it's disingenuous to say everyone is capable of making informed decisions; either through laziness, lack of understanding or purely out of being mislead they can make a poor choice with consequences they don't really "get".

In the choice you highlighted a commercial drugs firm could play the risks up and down to get someone to buy the more lucrative (or simply their) drug. I realise this happens already but organisations like the FDA limit this practice - mostly by banning drugs with serious side affects.

But if some people truly are incompetent

I believe I am talking about the majority here. I'm a smart thoughtful and cynical person but I am not sure I would be able to make an informed drugs choice in many cases. This applies in all sorts of aspects of our lives as well; I think we do need advisories and regulators in some areas to help us with these decisions.

[yummyfajitas]

Not exactly what I said.

What you said:

You clearly have the intelligence to make the decision... Will everyone be able to make such an informed choice?

It is absolutely true that people might make poor choices. Part of being an adult is making poor choices and suffering the consequences.

As for your concerns about false advertising, that is already illegal. Further, if you are truly concerned about misleading claims, keep the FDA, but reduce it to a labeling role. Then you get all the benefits of the FDA (provided you buy only FDA approved drugs), but I'm still allowed to buy drugs which meet my criteria but not theirs.

[ErrantX]

I dispute the way you interpret my original comment though. The point I was making was that I assumed you were, in this hypothetical situation, going to read the research and calculate the proper risks associated with the drug you choose.

If you dont then your not making a properly informed choice. I postulate that most people wouldn't - not through a lack of intelligence necessarily but all manner of reasons (laziness, misinformation, confusion, disinterest). Don't we have a moral right to avoid putting them in a position to accidentally choose a drug that kills you in a few years time?

This is the main point really; your example is very compelling (because I actually agree we should be able to quantify and choose our own risk). But I feel the real issue with de-regulation is that the drugs would have unknown future side affects.

Taking your example: what if the drug had only been tested and used for a year or so. You start using it understanding the risk so far discovered (fair enough) - but then in 3 years time it is discovered regular users are developing terminal cancers. What if they discover that any regular use brings the death rate within 5 years to 100%?

These are the risks regulation tries to balance out.

[yummyfajitas]

I may read the research, I may simply trust the (advisory only) FDA, I may trust my doctor, or I may take the average opinion of my doctor, the FDA and Consumer Reports. Whatever I chose, I feel my risk weighting is appropriate for me personally. Why do you feel you know better than I do what is best for me?

As for quantification of future risks, any individual drug has unknown future side effects. To quantify the risk, we quantify based on the reference class of all drugs:

P(unknown side effects | new drug) = (# drugs with bad side effects) / (# drugs with more than 5 years of use)

Suppose this number works out to less than 100 deaths per 100,000 drug users (I'm willing to bet it does). That is the death rate of commercial fishing. Assuming you don't favor having regulators ban commercial fishing, and assuming this number is less than 1 in 1000, would you favor changing regulations on new drugs?

If not, why not?

[wlievens]

Because competence of decision making is a spectrum. People aren't rational, period. There's no test for deciding whether someone is competent to make decisions regarding their health, so you can't declare them incompetent either.