Killing People to Help Them
When statists try to defend government regulations in
disputes with libertarians and others, they
often point to the Food and Drug Administration as an exemplar of the
good regulations do in society. This is
odd, because the FDA kills lots of people and causes many others unnecessary
suffering. That the FDA does this is indisputable. If there have ever been new drugs
or devices which save lives, and there have been, then the people whom they
would have saved who died in the time between when they would have been
available otherwise and when the FDA allowed them to be used were killed by the
actions of the FDA. Similarly if there
have ever been new drugs or devices which prevent suffering, and there have
been, then the suffering of the people
who would have been helped by
them in the time between when they would have been available otherwise
and when the FDA allowed them to be used was caused by the FDA. The FDA may
also save lives and prevent suffering. This is not as clear or obvious (at
least in recent times when fear of lawsuits offers such strong incentives for
caution) and depends more on conjecture,
but it may be so. It is certainly not clear that the lives saved match or
exceed the number of people killed or
that the suffering averted matches or exceeds the suffering caused.
A proponent of regulation could argue that a proper
version of the FDA would operate so as to prevent more deaths and suffering
than it causes and thus deliver an aggregate utilitarian benefit to society.
The first criticism of this is that such an FDA probably could never exist. The
deaths and suffering the FDA causes by delaying use of drugs and devices do not
cause sensations in the media or problems with legislators. The deaths and suffering caused by approving a
drug or device which later turned out to be dangerous would. Bureaucrats have
no incentive to worry about the former and every incentive to avoid the latter,
and people respond to incentives.
A more serious objection is that the employees of the government do not own
the citizens lives and have no right to dictate to a dying or sick person what
actions he may not take or what risks he may not run in an effort to recover. It is his life, not theirs. (The so called
social benefits are irrelevant. A person
being killed by the FDA is being killed, irrespective of what benefits the
agency may produce for some other people.)
A more reasonable system would be for each drug and
device to have a full disclosure of the protocols and procedures followed in
its testing and manufacture and for doctors and patients to be free to make
informed choices to try experimental or unproven therapies when they think a particular
situation warrants the risk. People who were averse to risk or not desperately
ill could consider only drugs and devices which had gone through the same
trials the FDA imposes today (or ever stricter ones). Others including desperate
people with little to lose would be free to take chances. Individual patients
and not their civil masters would have control over the decisions affecting
their lives. There would still be a role
for an FDA to verify the tests and disclosures and recommend best practices and
a role for trial lawyers to keep everyone aware of the costs of dishonesty or gross
incompetence.
Such a scheme would not be perfect. Mistakes and bad
choices would be made, and people would suffer and die from them. However, the
system would no longer be structured to produce suffering and death, and we
would be recognizing that each person, and not his betters in government, owns
and controls his own life.
Labels: FDA, Health care, individual rights, politics
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