Hacker News new | ask | show | jobs
by ErrantX 5906 days ago
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.

1 comments

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.

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.

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?

> As for quantification of future risks, any individual drug has unknown future side effects.

Meh, I already made this point previously :)

Obviously there is no way to make 100% sure a drug is safe without tests lasting at least the average lifespan of a person (etc.). But I think we have a reasonable medium at the moment; some drugs have long term affects that slip through, but for now the benefit is tipped in favour of "consumers"

Clearly drugs will end up having uknown effects. We have to balance releasing drugs quickly with understanding the most immediate risks they present.

The immediate problem with your figures is that they deal with current drugs regulation. I imagine they are limited by the regulations - and so if you remove them the figure may start to creep up (as dangerously undertested drugs hit the market). How far does it have to go before it's too far?

No, I approve of the idea of exploring ways to reduce regulation and open up industry. But total removal; seems a bit of a slippery slope :)