March 02, 2005
Are The Benefits Of Global Warning Underestimated?
Benny Peiser, a social anthropologist at Liverpool John Moores University in England, argues that global warming may bring more benefits than costs.
A large number of studies show that urban populations in the USA and Europe have successfully adapted to recurrent extreme weather events and heatwaves. People who used to be much more weather-sensitive only 30 or 40 years ago have become less susceptible to extreme climate conditions and heatwaves due to improved medical care, increased access to air conditioning, and biophysical and societal adaptations (4).
These studies essentially falsify the contention that future warming will lead to a significant increase of heat-related mortality rates. In fact, some of Britain's leading medical experts have calculated that a rise of the average temperature by two degrees Celsius over the next 50 years would increase heat-related deaths in Britain by about 2,000 - but would reduce cold-related deaths by about 20,000 (5). In other words, the decrease in the number of cold-related deaths would be much more significant (by a factor of 10) than the heat-related deaths due to rising temperatures. The potentially huge health benefits of moderate temperature increases have been confirmed by other researchers. They estimate that a warming of 2.5 degree Celsius would lower the annual death rate by 40,000 in the USA alone while reducing medical cost by almost $20 billion per year (6).
Very cold temperatures stress old tired hearts just as very hot temperatures do. If that is the biggest reason for the expected lowered annual death rates then my guess is that the dip in death rates would be temporary as a bunch of old folks got their day of reckoning shifted out by a couple
of years. Eventually their aged and weak hearts are going to kill them anyway.
As for people becoming less susceptible to the weather: Yes, this is definitely the case in industrialized countries. This trend has gone so far as to help catalyze a massive shift in the American population southward (and a similar trend is discernible in Europe though on a smaller scale). People can better handle the hot summers of the Carolinas, Georgia, Florida, Alabama, Mississippi, Louisiana, and Texas because they have air conditioning. Growing numbers of people live in Palm Springs California all year around (as compared to the previous practice of only wintering there) again because of affordable air conditioning. It is worth noting that the decline in climate-related deaths in America has happened in parallel with the shift of populations into areas with more extreme weather conditions.
The thrust of Peiser's argument is that global warming gloomsters tend to tally up only the costs of warming and not any of the benefits. I think he is right about that. Parts of the world that are extremely cold in winters will become more livable as the world warms. Finland, for example, might derive a big net benefit from global warming. Russians in Siberia might find it an improvement as well. Also, while weather patterns and, in particular, rainfall patterns will shift it is not clear to me that this will lead to a net decrease in agricultural production. Certainly growing seasons will get longer.
Though I think Peiser goes too far in his argument here:
Given the accelerated economic growth and technological progress in the developing world, successful adaptation to increasing or decreasing temperatures will become a universal feature in the not too distant future.
The bulk of population increase in the next 50 years will take place in what some call "developing countries". The problem is that a great many of those countries are not developing. Africa in particular comes to mind as the basket case of the world. Africa is glaringly failing to develop economically. Hotter temperatures are not going to be ameliorated in Africa with air conditioning. Also, India's rate of economic development is lagging China's and Burma/Myanmar is not a poster child for economic development (though that might change as China's influence there gradually turns the place into a virtual colony of China).
But suppose improbably that all the less developed countries could miraculously follow China's pattern of economic development and a few billion more people could afford to buy air conditioners. Such a massive increase in buying power would cause an enormous increase in fossil fuel burning and an atmospheric carbon dioxide (CO2) rise that would be greater than the current pessimistic climate forecasts. If we could even find the fossil fuels to burn we'd face an environmental disaster. Air conditioning the whole world with fossil fuels does not strike me as a realistic option.
If fossil fuel use is restricted by regulatory regimes aimed at reducing CO2 then the higher costs of air conditioning in the summer and heating in the winter will reduce the use of heaters and air conditioners and lead to more weather-related deaths in industrialized countries. But while those deaths will rise other deaths from heat will likely be avoided less developed countries which are mostly closer to the equator than the industrialized countries.
What we need are technologies that provide cheaper and less polluting energy. If we had those technologies we would not need to spend so much time arguing about green house gasses and climate projections. Rather than saddle the industrialized economies with very high taxes on fossil fuels to reduce energy use with a resulting slowing of economic growth why not launch a Manhattan Project to develop new energy sources?
Nobelist Richard Smalley points out that if we only had a cheap way to collect it the solar energy hitting the Earth is enormous.
By the year 2050, the current world population of 6.5 billion is expected to increase to a possible 10 billion. According to Smalley, the energy required to maintain this population will theoretically more than double from the 14 Terawatts used per day in 2003 to 30-60 Terawatts in 2050.
In his argument, Smalley showed that 165,000 TW of energy from the sun hits the earth's surface every day. "We only need 20 to completely sum up the world's energy needs," Smalley said.
Solar satellites anyone?
Smalley thinks "Peak Oil" is coming and maybe soon.
Because right now, we have 6-and-a-half billion people on the planet of which about only 1 billion are really consuming energy at a significant rate. Those other 5-and-a-half billion people are going to, there's no way to stop it. We don't want to stop it, consume energy. By the middle of the century, at least a factor of two more energy will be produced every day. Right now it's about 200 million barrels of oil every day are burnt up one way or another. Either as oil or as gas or as coal or other energy sources.
By mid-century we're going to need at least 400. Where's that going to come from? Well if it has to come from oil, and the way that we're used to getting it, the low cost we're usually getting it, it's not by any means certain there will be that oil there. In fact, we may peak within the next couple of years or the next 10 years. By mid-century we will have peaked, so where are the billions of people on the planet going to have their primary energy coming from? Where?
Note that China is going to add another billion to the set of people who use energy at a significant rate.
Smalley calls for $10 billon per year to be spent on a Manhattan Project to develop new energy sources.
Smalley believes that nuclear fission power is the only realistic energy alternative to fossil fuels but only in very stable societies that can safeguard it properly. (note that this is from 1996 and so his "next century" is the 21st century)
Right now, I believe there really is only one alternative that could really apply to the energy needs of the entire planet. That alternative is nuclear—nuclear fission in particular, not nuclear fusion.
"I believe that the United States, Europe, and Japan are stable enough societies that they could generate all their power by nuclear fission and provide the necessary stewardship to make the planet safe...
"It would be very nice to have an alternative to fossil fuels—an alternative to nuclear fission—that would be capable of providing energy for what will probably be 10-15 billion people in the middle of this next century. I believe that if this alternative exists, it has to be solar. Right now we do not even have a solar technology that is even laughably close to being able to handle—for example—80% of all the world's energy production. If you don't do 80%, you're not touching the problem. And if you don't provide energy technology that is economically cheaper than the alternatives, it won't be adopted at all.
"Where is that solar technology going to come from? [It will come] not just from improving solar cells, but from something totally new. On a cloudy day in New York, can take most of the photons that hit on cheap collectors and store it in some useful form of energy—like hydrogen or electric charge. When you think about the physics that controls that, you're rapidly led to the conclusion that the physics which makes this possible happen within a little, 1 nm cubic box....
"I don't know what that solar technology is going to be, but I'll bet you that it's nanotechnology."
One really big advantage that would come from solar cells built using nanotechnology is that they would be safe enough for the whole world to use. We ought to be developing better nuclear reactors (e.g. pebble bed modular reactors) for the developed countries and doing nanotechnology research into photovoltaic cells to make photovoltaics orders of magnitude cheaper.
We need to start working seriously on alternatives to fossil fuels.
Smalley does not inspire confidence. He says we might hit peak oil in two years. Or maybe 5 years. At least he knows we'll hit peak oil within 50 years. Or not. Sloppy.
His debates with Eric Drexler made him look very small indeed.
We are going to hit world peak oil. We do not know when. Smalley is being realistic when he says he does not know exactly when it will happen. Lots of countries have hit their peaks. The number of countries that have hit their peaks keep getting larger. 50 years is a realistic outside estimate of when the world peak will be hit.
My guess having read many arguments on the subject is that the peak is going be hit in 10 to 20 years. Though the rise in oil prices over the last few years makes me think perhaps the peak will come sooner. An increasing fraction of what is called "oil" is stuff converted from natural gas. Well, natural gas's peak is going to come too, probably a few years after oil's peak.
We might still be able to keep a fossil fuel economy running longer by using natural gas from clathrates. But then again, more recent estimates of clathrate reserves are much lower than the more optimistic estimates of 5 to 10 years ago.
Everyone take a big breath -- as a matter of history, we have never run out of anything because of functional substitution. This is a universal economic principle. It will happen again with energy and we will be either a solar, nuclear (fi/fu), or harvested biomass economy then. Energy companies, if not terribly interfered with, will adapt and bring us what we need. In other words, the invisible hand works, and will work again.
Hell, in a pinch we could put up huge solar-based power stations in orbit, and even tho the efficiences suck, you could still microwave the stuff down to Earth. We will lose a few birds of course, but hey, too many pigeons already anyway...
Developing countries will self-destruct or evolve. It really is that simple. We are going to see some truly horrible humanitarian disasters if they don't wake up and smell the coffee of free market dynamics. Whatever our criticisms of capitalism, free markets deliver for the most part -- socialist/forced based economies don't.
To pile on the logic from Robert, I believe it was Texaco (?) or another oil company that had financed the development of the first photovoltaic cells. Energy companies are the ones with the most to gain from alternative fuel sources, so it makes sense to let the free market dictate the R & D of these sources. Government mandated "manhattan projects" seem like an accident waiting to happen to me.
Would you abolish the National Science Foundation and the National Institutes of Health and let the free market be the only source of scientific research funding?
The market underfunds science. There are obvious reasons for this. One reason is that much knowledge is not ownable. Much of what scientists publish can not be patented or otherwise made into intellectual property. So the market provides little incentive to fund science. Yet science produces huge amounts of value for everyone.
The market also does not internalize all costs and make those costs show up in production costs and product pricing. Pollution is one source of uninternalized costs.
The market does wonderous things. But the market is not a panacea any more than the socialists love of more government control is a panacea. The market has flaws and limits. Not only in science but also in technological development and innovation the market underrewards innovators. See Tyler Cowen's post "The returns from innovation" where he reports on an economic study that shows only 2.2% of the value of innovation flows to the innovators. This means a lot less than the optimal amount of innovation gets done.
A Manhattan Project aimed at making a single product or a single design will not work for energy research. But provision of money thru normal granting mechanisms to fund a large assortment of different projects aimed at developing better methods to produce and store and use energy would allow a large number of scientists to pursue their own ideas for how to solve our energy problems.
Is it just me or did most people sleep through high school physics? See if you can find the nonsense in this quote:
"In his argument, Smalley showed that 165,000 TW of energy from the sun hits the earth's surface every day."
A terawatt is a unit of *power*, not energy. The earth does not receive "terawatts per second" it receives terawatts. It does receive *joules* per second, since a joule/second is a watt. Look at the printing on a lightbulb, it consumes 60W and not 60W/s or 60W/h or any other measure of power per unit time.
One should never say that the earth or the United States or one's house consumes so many terawatts of power per day or per year. It doesn't make any sense and it suggests that one is ignorant of basic science.
The real problem with "global warming" is not the warming, it is abrupt changes in the climate. Recent studies of ice cores from Greenland and Antarctica make it clear that the earth's climate is capable of highly chaotic, very rapidly changing behavior. For the last seven thousand years or so, the earth's climate has been unusually stable, but by pumping the largest amount of greenhouse gasses into the atmosphere that we have ever measured in a very short time, we are effectively hitting a quasi-stable, chaotic system with a sledge hammer and we are about to see what happens. In the past, the climate has changed some 14 degrees F in fifty years or so, about an order of magnitude more than the climate models for standard global warming. Once we hit the 'tipping point' of climate change we could find ourselves in in a chaotic mess where the climate of a single point on earth could go from a temperate forest to a desert to a rain forest to tundra in a single lifetime. Conventional agriculture would be impossible and the developing world would collapse. Unfortunately, since we are talking about a chaotic system, getting very specific about a prediction is very difficult. We know these things happen by observation.
Also, you have written about clathrates a few times, but I don't think you are aware of the problems of exploiting those reservoirs. Some of these methane hydrates occur in relatively stable environments like permafrost regions in the arctic, but most of them occur in narrow P/T environments on the continental slopes in unconsolidated sediments. Because they occur as solid ice filling pore spaces of sediments they are mechanically like frozen, wet sand - about as hard and strong as cement. But since you need to change the pressure or temperature in order to free the methane, the sediments will go from hard, strong rock to bubbly mush overnight. Since this is on a continental slope, if a slope failure is initiated, uncovering the clathrate rock could initiate a chain reaction of slides and clathrate instability, releasing billions of tons of methane, a very potent greenhouse gas, very quickly. There is pretty good evidence that exactly this sort of climate catastrophe has occurred in the past (http://pub39.ezboard.com/fhuntforplanetxfrm29.showMessage?topicID=53.topic) . I wouldn't want to be the guy insuring those operations.
I tend to just filter out reporter misuses of terms like energy and power. I get the underlying point that is being made and ignore the imprecision.
As for watts per day: Sure, you have a valid point. But we do speak in terms of kilowatt hours to mean a kilowatt rate for an hour.
Yes, I've seen ice core temperature charts going back 11,000 or 12,000 years for the Earth. I even have linked to some of those charts. Yes, there have certainly been some abrupt swings.
BTW, not sure where you are located. But in California the University of California has a TV channel (which I know is carried by some of the satellite TV services nationwide btw) that sometimes broadcasts scientific lectures (thought it seems to more often broadcast some lousy avant garde music performances and other nonsense) delivered at UC campuses. Sometimes they have Scripps people lecture on climate history and the ocean's interaction with the atmosphere. They had a Scripps guy (whose name escapes me) recently talk on the abrupt swings in the climate and on the CO2 forcing effect on the climate. He showed the Greenland temperature data too. Yes, it is scary stuff. What if we are forcing the climate toward an oscillation? Then again, he admitted we could be lucky and might be forcing it away from some inevitable future oscillation. But he thought that possibility less likely.
My take on it was that sure do need better means to measure and predict future climate events.
Also, we sure do need cheaper solar and cheaper batteries and cheaper fuel cells and cheaper nuclear power.
And we will get "cheaper solar and cheaper batteries and cheaper fuel cells and cheaper nuclear power" when fossil fuels get to be too expensive.
Just like we are not making significant progress on earthquake prediction, we may be approaching fundamental limits on predicting climate, because they are both classic chaotic systems.
I know we always here about "breakthroughs" in solar technology, but this one looks more interesting than most (to me).
I would buy solar panels for my house if it was anything close to economical, which today it is not. But it is only off by a factor of 4 or so, so we are getting close.
I wouldn't put too much stock in the numbers/units/details in Smalley's speech (or maybe it's a problem of translating it into a general interest article.) After all, the statement that "When you think about the physics that controls [solar energy], you're rapidly led to the conclusion that the physics which makes this possible happen within a little, 1 nm cubic box...." cannot be right. The peak wavelength of sunlight is ~500 nm, so the material has to be around that size just to absorb it.
That said, I think Smalley's right that solar is poised to dominate the energy portfolio 75 to 100 years from now. But before then, we'll need some bridging technologies--or more like every bridging technology we can get our hands on.
Also, for those who want to zero-out government funding of energy, remember that the nuclear power industry would have no future without it. The private investment in nuclear power is minuscule compared to government research.
So then are you content to wait until fossil fuel market prices become much higher before we get those breakthroughs?
The assumption underlying my position that we should push for breakthroughs is that there are costs of fossil fuel usage that do not show up in prices. I am not content to just wait for the market to produce a solution because I want less ground level pollution, I want less risk that green house gasses might send the climate into some big shift, and I want less reason to have to involve ourselves in the Middle East with a lot of American blood and money.
Realistically, the alternatives to fossil fuels are nuclear power and space-based solar power. New nuclear plant technology includes the integral fast reactor and the pebble-bed reactor. Both technologies are being utilized by the Chinese in their quest for lots and lots of energy. Space solar power was first proposed by Peter Glazer in the late 60's and expanded apon by Gerard O'Neill and the L5 Society (remember them?) in the 70's. Given that nanotubes could be used to build a bean stock (both Earth and Moon) as well as recent dicovery of many NEOs, this idea has more going for it now than it did in the 70's. New materials for the collecters themselves also makes this a more promising prospect.
Of course, we have o get rid of the gay government bureaucracy of NASA and get on with commercial space development before the space solar power concept can be realized.
The problem with wind, Earth-based solar, and what not is that they simply cannot generate the concentrated gigawatts and terawatts of energy that is required for a modern civilization. Energy is a commodity and like any other commodity, is generated in bulk scale and sold cheaply. Piddle-power schemes do not recognize this reality.
We need to fix our nuclear regulatory system so that new nuke plants can be built.
Let them operate under reasonable, stable rules (no overhauling the regs during plant construction!), and investors will build them when they judge that high oil prices are here to stay.
As for the rest of the world? Build more nuke plants here and sell them hydrogen. Run our cars on it too - there's no reason we can't run our transportation infrastructure (indirectly) on nuclear power as well as our electrical infrastructure.
The alternatives are to burn coal (not exactly Earth-friendly) or get used to a more provincial, more primitive, and more labor-intensive lifestyle than we've seen in generations after peak oil drives prices permanently skyward. Compared to the danger and hardship involved in that, a nuclear plant is unbelievably safe.
"So then are you content to wait until fossil fuel market prices become much higher before we get those breakthroughs?"
Actually no. I was just stating the likely case based on the current policies. I agree wholeheartedly with your position. Even though you could call government funded alternative energy-related research "corporate welfare", I think that you would find a consensus amoung the populace that it is public spending in the public interest in that it reduces pollution and increases the efficiency of our economy in the long run by broadening our energy mix and reducing dependency on very risky supplies of foreign oil.
In regards to the earlier comment would one eliminate the NSF and NIH?
Yes -- I would. As fast and as viciously as I could. Along with the FDA and its 50 state equivalents.
The existence of these agencies acts as a black hole that improperly allocates resources while unintentionally suppressing private research because of parasitic thinking on the business side. E.g. If I am a business, I'm taxed business level and personal level, I will parasitically feed at the trough and live downstream of these "controlled econommy" agencies when they come up with something useful. (Or I coopt them, as per the Japanese fascist kieretsu model)
I wonder if anyone would stomach these kind of things if the New Deal hadn't been rammed down our grandparents throats (especially since the Fed Reserve caused the Great Depression in the first place).
Am I to understand that you are a supporter of the "free market system" and don't care for government regulation? Do you see government as strictly a force of tyranny? That is not the concept of our founding fathers. As you might recall, they thought we had “certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness.--That to secure these rights, Governments are instituted among Men, deriving their just powers from the consent of the governed.” I have no trouble seeing, say the FDA, as an agency that secures the rights of the populace not to be deprived of their lives or happiness by companies that, because of criminal negligence, creates drugs that kill tens of thousands of people. Why is that not a legitimate role of government from your perspective? You would prefer that the free market manage the situation by causing the company to simply go out of business after the people died? How is a pharmaceutical company killing people by not ensuring their drugs are safe fundamentally different from a bank robber who steals money from the public? Don’t we reasonably expect the government to secure our rights by stopping criminal activity in both cases? How can that be done without regulating the activities of corporate entities just as your and my activities with regard to robbing banks are regulated by the government? Why should corporations be allowed to pollute and thereby kill members of the public when you and I have to pay to have our garbage collected? Laissez faire economics just doesn’t stand the smell test.
In the same way, I believe that the extraordinary amount of criminal abuse of the financial markets that caused the stock crash in ’01 was clearly due to the “deregulation” frenzy of the late ‘90s that gave corporate criminals the ability to lie about their corporate finances. As a result, small investors were deprived of trillions of dollars of, shall we say, happiness. That is not a good result. I am of the opinion that a criminal is a criminal whether bank robber or corrupt corporate executive and that for the good of the public, they both should be stopped. Regulations are the laws that protect the public from criminal corporations. If they do not have that effect, they should be eliminated.
And I would further suggest that if government funded research will have the effect of creating a smoother transition to a sustainable energy economy, that is a good thing for the public, it will enhance the happiness of the populace and is therefore a reasonable activity of government. If such research is unlikely to have that effect, it can’t be supported.
"I have no trouble seeing, say the FDA, as an agency that secures the rights of the populace not to be deprived of their lives or happiness by companies that, because of criminal negligence, creates drugs that kill tens of thousands of people. "
But the FDA itself deprives the rights of the populace to preserve their lives and pursue happiness by forbidding them to buy drugs for several years after they are invented, and forbidding them to buy some drugs forever.
Not every unforeseen effect of a drug is "criminal negligence". By the very nature of the human body, most drugs will have unforeseen effects, and people should be allowed to buy newer drugs knowing that they probably will have unforeseen effects. Some people are in more danger from not taking the drug, and others should be allowed to risk their own lives to pursue happiness. We have a right to keep our lives without being unjustly deprived of them by government or our fellow citizens; we do not have a duty to preserve our own lives at all costs, especially the cost of our right to pursue happiness.
"And I would further suggest that if government funded research will have the effect of creating a smoother transition to a sustainable energy economy, that is a good thing for the public, it will enhance the happiness of the populace and is therefore a reasonable activity of government."
But the research has already been done and a sustainable method of obtaining energy already exists - nuclear power. It is government that is preventing this existing technology from being exploited, and in lieu of further government research, government should allow existing technology to be put to the use that it is already well-suited for.
I find the lack of actual results undermines your argument with respect to the FDA. You predicate your argument on "if the FDA protects the populace", but I see no evidence of that. The number of deadly drugs released to the public over the last 20 years shocks me. Most of these debacles do not receive the same level of press as phen-fen, but the people killed are just as dead.
The FDA arose out of the horror of thalidimide. The only difference between that incident and the post-FDA incidents is the shock value of the pictures. Dead sick people do not create the same hysteria that flipper-like appendages do. Deformed heart valves lack the shocking sensationality of deformed babies.
The FDA will do nothing to prevent another thalidimide. Unfortunately, given my dim view of human nature, when that happens, I expect the people of the US will replace the FDA with something even more controlling and bureaucratic and even less effective.
I find your beliefs regarding the cause of the stock market crash of 2001 questionable. What caused the crash amounted to mass hysteria. The same sort of hysteria that caused every bubble from the tulip bubble and after. A vicious cycle of anxiety and greed drove the asset price to irrational highs from where it had nowhere to go but down. I do not find a few predators feeding off the irrationality at all surprising. In fact, instead of looking at Enron et al as a cause of the crash, I am surprised at how few of these predators were flushed out by the eventual correction.
"Not every unforeseen effect of a drug is "criminal negligence". "
Right. And some effects are. When a company knowingly suppresses evidence from legitimate research that their drug kills people while providing no benefits beyond existing, proven medicines, that is criminal behavior that the public should be protected from. You seem to advocate any shyster being able to sell any poisons, making any claims he wishes, killing his hapless customers without consequences. On what basis can patients make decisions to " risk their own lives to pursue happiness" without reasonable standards of research and disclosure? What you advocate has the effect of chaos and murder.
"It is government that is preventing this existing technology (nuclear) from being exploited..."
That statement is far from the truth. It is the government that did the research that gave the nuclear industry its start and it could not continue without massive government assistance. If nuclear is so viable in the "free market" why does the government have to excuse the nuclear industry from liability for nuclear accidents via the Price-Anderson Act? The nuclear industry was not viable without the corporate welfare of the PAA before the advent of high tech terrorism and it certainly isn't now. Current power reactors are highly susceptable to terrorist attacks that could cause damage in the trillions of dollars. The public should not be subjected to those risks for the benefit of corporate entities when viable alternatives exist. And they do.
"I find the lack of actual results undermines your argument with respect to the FDA."
Phen-Fen was one of the first drugs approved after the FDA was forced by Congress to speed up the approval process, primarily by AIDS activists. Obviously, AIDS patients don't need drugs to lose weight, but the pharmaceudical corporations took advantage of the opportunity to sell drugs that were highly dubious in order to cash in billions of demand for anti-fat drugs. No regulatory system will ever be perfect, but "we can't let the perfect be the enemy of the good." The public must be protected from unscrupulous corporations as against other classes of criminals. Period.
The market only works efficiently and to the benefit of the public if there is an efficient flow of good information in the marketplace. Ensuring the validity of that information is a valid and good role of government to protect the public from fraud. When government abdicates that role as it did in the late 90's, the public is ripped off. Every time.
The arguments for and against the FDA are not really relevant to arguments for or against government funded research.
In the case of the research it can be argued that the market can not efficiently reward knowledge generators because a medically useful discovery comes as a result of work accumulated by tens or hundreds of thousands of research labs. How can the invention of a drug or of a better clinical practice be traced back to all the people who ruled out some approach thereby encouraging a different approach? Or how to account for, say, the development of an assay that gets used to do a test that leads to 10 other tests that lead to the development of another assay technique that 10 years later causes some scientist to see a way to cure some disease? The market does not work for this.
The FDA is a different matter. On one hand we have the views of people like T.C. Dean who see the FDA as protecting ignorant people from fraud. On the other hand we see families of terminally ill patients arguing that the FDA can't possibly protect them because they already have a fatal disease so why not be able to try experimental therapies?
In fact, the argument can be made (and I've made it) that the FDA could be left with its current powers over most drugs but not over drugs which are aimed at treating fatal illnesses. If someone has, say, 1 or 2 years life expectancy they should be given a "get out of the FDA jail free card" to allow them to try any experimental drug that exists in labs.
Also, there is the economic argument that while the FDA may protect people from particular harmful drugs it so raises the cost of drug development that far fewer drugs get developed. The first part of the argument seems obviously correct to me. People who make this argument claim that abolishing the FDA would lead to the development of so many more useful drugs that the number of people killed by bad drugs would be far outweighed by the number saved by the development of more life-saving drugs. I do not think this argument can be easily dismissed.
But the question of whether the marketplace has the incentive to fund the optimal amount of research is a lot more important than the question of whether the FDA should be abolised or at least scaled back in its power.
"...we have the views of people like T.C. Dean who see the FDA as protecting ignorant people from fraud."
That is not a very complete exposition of my argument, although it is true that the entire public is ignorant about the efficacy and safety of drugs if research based on reasonable standards is not open to the public and incorporated into warnings about the drugs. The recent Vioxx story is illustrative. Merck proved themselves perfectly capable through their marketing efforts to be able to convince doctors and masses of patients that a marginally effective and exceedingly dangerous drug was the best thing since sliced bread and they made billions doing it. Why is it that people have an abiding fear of the FDA, which was created to protect the public, and don't seem to worry at all about a huge mega corporation with every incentive in the world to sell ineffective poison? A corporation which exists to maximize it's profits is definitely not going to voluntarily commit the necessary money to properly analyze it's drugs and especially if they are to be protectd from liability by restrictions on class action lawsuits. If it is expensive to protect the public from dangerous drugs, then it is expensive. It is reasonable to analyze the cost effectiveness of ensuring the safety of drugs, but doing nothing to protect the public is certainly not a viable option.
You argue that terminally ill patients are reasonable test beds for the drug companies because "...they already have a fatal disease so why not be able to try experimental therapies?" I would answer that even (and maybe especially) terminally ill patients should be protected from losing their limited funds available to save their lives from fraudulent treatments sold by scam artists taking advantage of the desparate. Certainly drugs that are promising for terminal diseases should be rushed through the testing process as fast as possible. And there are large numbers of tests of new drugs for which patients can make themselves available.
Any way to relate this to the current topic? Perhaps by suggesting that a viable role for government is to do the research to protect the public and enhance their well-being and to set reasonable standards for all research. It seems obvious to me that the private sector has no incentives whatsoever to engage in climate research, but it can be very significant to the public well-being. Then based on that research, the true cost of the various forms of pollution from human activities can be computed and accounted for in the marketplace. That is, fuels and machines that pollute the most should be taxed in a way that pays for damage remediation and low pollution methods might be subsidized or at least taxed at lower rates.
Public ignorance: So how about allowing drug companies to bring drugs to market without phase III trials if all phase II safety data is made publically available for download from a web site?
So you do not think that terminally ill people should have the right to decide to try unproven treatments?
Suppose some guy is rich. Suppose he has 6 months to live and his house is worth $1 million. What are you protecting him from?
Clinical trials of new drugs: It is not so easy. Speaking as someone who has a family member who is dying of cancer I can tell you that getting into drug trials can require more exertion than a cancer patient can handle. One might need to fly up to, say, Johns Hopkins or Duke (real examples - I made the calls to the test coordinators) once a week or once a month to get a new treatment. That may be beyond what the strength of the patient can withstand. Just sitting on an airplane without instant reliable access to a bathroom may be too much depending on disease type and point of progression.
Now, if new drugs under development could be administered by any oncologist suddenly the drugs would become available to orders of magnitude more people.
"Suppose some guy is rich. Suppose he has 6 months to live and his house is worth $1 million. What are you protecting him from?"
I'd say that even rich people and their heirs have a right not to be ripped off. I think it is reasonable to protect terminal patients from spending their money and limited time pursuing ineffective treatment when effective treatments might be available. Without question, drugs for terminal conditions should have different testing schedules than run-of-the-mill drugs/conditions. The cost/benefit of all regulatory activity should be monitored and analyzed continuously. If it is doing more harm than good it should be altered. I doubt we disagree about that. It does seem reasonable to try to make trials of experimental drugs as widely available as is reasonable based on the details of the protocol for the experiment. I am sure it is difficult sometimes. Sorry about your relative.
"I'd say that even rich people and their heirs have a right not to be ripped off."
Rich people may have a right to be "ripped off", but their heirs have zero rights concerning that money until they actually inherit it. No one has a duty to leave the heirs anything to inherit, and laws restricting the people from spending every last cent they have to buy a chance, however small, of saving themselves are profoundly unjust.
You can't restrict only one side of an economic exchange. If you forbid the corporations from selling something, you are simultaneously forbidding consumers from buying it. This is only appropriate if you assume that those consumers never actually grow up and need parental guidance their entire lives.
The idea that the FDA needs to bless medicines before anyone's allowed to buy them makes about as much sense as the idea that some federal agency needs to bless every marital union before it's made, lest you unwittingly marry someone that will end up killing you. The way to deal with fraud is to punish the perpetrators after the fact, and to define "fraud" so it includes deliberate hiding of information but not unforeseen circumstances or situations where the buyer knows or reasonably should know that the product might have unknown side effects.
Yes, it's a fuzzy line, but it's better than dividing the human race into exploitative corporations, overgrown children, and wise regulators. That is a poor fit with reality, and very little good and much harm will tend to come of it.
"This is only appropriate if you assume that those consumers never actually grow up and need parental guidance their entire lives."
So, are you able to determine that a given pill is effective or safe by looking at it? On what basis can a consumer judge drugs? I guess if one's neighbor takes it and he doesn't die the drug is safe? The estimates are that 55,000 Vioxx consumers are now dead who otherwise wouldn't be. What would be appropiate to "punish the perpetrators after the fact"? Slaughter the upper and middle management of Merck? The line isn't fuzzy at all. Your laizzez faire BS is so absurd as to not warrent serious discussion. Based on the accutarial value of a human life that little oversight on the part of Merck and a hobbled FDA is worth $110 billion. Mightn't it have been cost effective to do another million dollars worth of research and delay the release of a worthless drug another six months or a year? The only thing fuzzy is your logic and your sense of morality.
By mentioning VIOXX, you prove my point that the FDA does nothing to protect consumers. I mentioned Phen-fen only because it is well-known. It is far from the first case of an FDA approved drug killing people. The examples go back decades.
Rather than protecting people from their own stupidity, paternalistic statutory regulatory bodies impose their own stupidity. If a wealthy individual spends the money without doing any due dilligence, that is their own problem. If I had $1 million to spend and a potentially fatal disease, I might spend the money desperately but not stupidly.
I agree with Randall that this is all beside the point. The real question is whether the market sufficiently rewards certain kinds of science and whether those kinds of science would benefit the public good.
"By mentioning VIOXX, you prove my point that the FDA does nothing to protect consumers."
No it proves my point that the "deregulation" frenzy of the late 90's, fueled by billions in legal bribery from the pharmaceudicals to our totally bought off politicians has made the FDA ineffectual. Only when the deaths of tens of thousands of consumers makes headlines is the public even vaguely aware of the extent of the political hobbling of regulatory agencies. There are good scientists who risked their careers by trying to warn the public about Vioxx and other drugs, but they were effectively muzzled by political operatives stuffed into the FDA leadership by the pharmaceudicals using all the political influence that their money can buy. These days, industry insiders who previously had fought for the dissolution of regulation now run those regulatory agencies. That is the most effective possible situation since they can pretend to protect the public while actually serving the interests of industry.
The question about science that we should be talking about is the massive extent to which political operatives installed in regulatory agencies have been blatently influencing research, supposedly in the public interest, and concealing negative results on behalf of their true clients, deep pocket industries. Thousands of scientists have signed petitions and resigned their positions in Federal agencies in protest of this dispicable situation, but the public shows little concern. Let's talk about that if you are concerned about the "public good".
Bob, one more point...
"Rather than protecting people from their own stupidity..."
I am not suggesting the people who took Vioxx or the doctors who prescribed it were stupid. That is the old right-wing line. Rather they were completely taken in by billions of dollars spent on incredibly sophisticated marketing campaigns, completely unbalanced by unbiased scientific research disclosure. Studies by the Harvard school of medicine show that the reasons given by doctors for prescribing hugely expensive new medicines rather than equally effective generics match perfectly with the pharmaceudicals' marketing information, not results of research. When information channels are so completely dominated by corporate interests, that is what people respond to.
You seem to be advocating that each consumer of medicine should do a weeks worth of research at the library before they take a new medicine. Shall we go back to the days of patent medicine shows?
"These days, industry insiders who previously had fought for the dissolution of regulation now run those regulatory agencies. That is the most effective possible situation since they can pretend to protect the public while actually serving the interests of industry."
And this is an argument for keeping the FDA in the driver's seat?
The best way to keep industry honest is to leave open a realistic possibility that newcomers will barge into the field and steal away all the customers. Regulatory agencies such as the FDA are designed to prevent this from happening, and along with their other faults keep incument vendors from being bothered by such upstarts and let them make money selling crap. Just think what kind of overpriced junk heaps we'd be driving if the industry flacks in Detroit had gotten their way with regard to trade policy back in the 1980's.
The compromise "deregulation" of the 1990's shows the folly of such half measures. The FDA and other agencies like it need to be shut down, the buildings and other assets they hold sold off to people that will do something genuinely useful with them, and the vendors they "regulate" thrown out in the cold and forced to deliver real results - better results than anyone else on Earth can - for a living.
"I am not suggesting the people who took Vioxx or the doctors who prescribed it were stupid. That is the old right-wing line."
No, that's the old left-wing line - that not only are the "masses" stone cold stupid and in need of lifelong parental guidance, but that medical professionals with 12 years of advanced study are easily bamboozled by those evil corporations, whose machinations only the wise and all-knowing regulators can see through. (Although those doctors have their own exclusive racket, and better ones might be in practice if we broke up that racket...)
The right wing line is that people generally aren't stupid and can manage to take care of themselves in most cases, especially if their own money or health is on the line.
"You seem to be advocating that each consumer of medicine should do a weeks worth of research at the library before they take a new medicine."
Actually, I'm advocating that the medical professionals that charge so much for their "professional advice" do some research to back up their advice - and if they don't, someone else ought to be able to come out of left field and steal away their customers. And consumers ought to be free to ignore advice from any source, whether it be an M.D. or a Federal agency or a drug vendor, that has proven itself untrustworthy.
You really are not listening.
I will reiterate my agreement with Randall: The real question is whether the market sufficiently rewards certain kinds of science and whether those kinds of science actually contribute to the public good.
"And this is an argument for keeping the FDA in the driver's seat?"
No, it is an argument to reform the FDA so that it actually protects the lives of the public rather than pretending to do so by prohibiting industry hacks from controlling the regulatory machinery. Why isn't that obvious?
"The right wing line is that people generally aren't stupid and can manage to take care of themselves in most cases, especially if their own money or health is on the line."
A logical extention of that laissez faire philosophy is that we don't need policemen to apprehend bank robbers or murderers, because people should take care of themselves. The fallacy behind that appeal to the law of the jungle is civilization requires government "to secure these rights" as my hero Tom Jefferson properly pointed out in the Declaration of Independence. You haven't in any way answered my point questioning how a consumer of drugs would be able to judge the efficacy or safety of drugs on his own if proper research and disclosure weren't required by a regulatory agency like the FDA. What is the incentive for a pharmaceudical company to do such research? They certainly didn't do it before it was required by the FDA. In the case of Vioxx, some 55,000 people died because proper research was not done before the release of the drug and when it was, the results were allowed to be hidden due to the hobbling of the FDA. Without the FDA how would anyone even know excess people were dying when they took the drug? Heart attacks happen every day and the relationship is not at all obvious. I maintain that a well regulated pharmaceudical industry could have eliminated nearly all of those deaths by requiring proper research and disclosure. Why is that not a good result in the interests of the public welfare and why isn't it cost effective in the long run? You think it is OK for an industry to kill tens of thousands of people and then to simply go out of business? What is wrong with your sense of justice and morality? That's what I want to know. Why don't you answer my point about how the public would protect itself from lethal drugs if all information about them were controlled by the pharmaceudical companies? It's because you can't. You can only spew ideological propaganda.
"Actually, I'm advocating that the medical professionals that charge so much for their "professional advice" do some research to back up their advice".
Like most of us, doctors do what they are paid to do, and that is to treat patients. They are also paid by pharmaceudical companies to dispense their drugs via expensive trips to seminars, free drugs, expensive dinners... Have you ever been to a doctor's office and not seen a drug peddler there? It would be wonderful if doctors were all geniuses and saints. But since they are fallable humans they need good unbiased sources of information and they need to be disciplined if they kill people by selling them bad drugs. That is why we need effective government to secure the rights of the public to life, liberty and the pursuit of happiness. Some liberties are not consistent with a just civilization and amoung those are pharmaceudical companies' right to sell lethal drugs and your right to rob a bank. Any questions?
"You really are not listening."
Really, really it is you who is not listening. As far as I can tell, I am the only one who has actually addressed that issue. Check my post of March 4 where I was desparately trying to get the discussion back on topic. It is the numbskulled ideologues who keep diverting the subject:
"Any way to relate this to the current topic? Perhaps by suggesting that a viable role for government is to do the research to protect the public and enhance their well-being and to set reasonable standards for all research. It seems obvious to me that the private sector has no incentives whatsoever to engage in climate research, but it can be very significant to the public well-being. Then based on that research, the true cost of the various forms of pollution from human activities can be computed and accounted for in the marketplace. That is, fuels and machines that pollute the most should be taxed in a way that pays for damage remediation and low pollution methods might be subsidized or at least taxed at lower rates."
So do you have anything to say on the topic or are you happy to just continue repeating the question?
You focus on the sellers of treatments in your discussion of rights and in the process you ignore the buyer's rights to take risks when the downsides are small. As far as I can tell you simply oppose a dying person's right to spend their money on unproven treatments because you put regulation of pharma cos ahead of a patient's right to try any treatment.
I don't think there is anything left to debate here.
"As far as I can tell you simply oppose a dying person's right to spend their money on unproven treatments because you put regulation of pharma cos ahead of a patient's right to try any treatment."
Well, we can certainly debate whether or not you understand my position. I would propose you don't. Perhaps you should try reading carefully and then thinking and THEN responding.
The principle in question is about informed consent. I am against a company being able to make false claims which cannot independently or reasonably be questioned in order to sell a worthless or harmful product. Without unbiased and independant research relevant to the efficacy and safety of the product, a patient whether healthy, sick or dying cannot make a reasonable and informed decision as to whether a given drug will extend his life or cut it short. Being able to make that decision is in the interest of the consumer and society ingeneral. You seem more interested in protecting the con man than in protecting the sick and dying. Debate that.
And one more fallacy: "...you ignore the buyer's rights to take risks when the downsides are small."
If a terminally ill person chooses, based on fruadulent and false information, to take a drug that is ineffective or worse, harmful, when he might have spent his money and last days with a treatment that actually could cure, that is not a small downside. I would say it is more like murder. Would you like to retort?
Wrong. Plenty of terminally ill people are willing to try experimental therapies knowing fully well that the therapies are unproven and may turn out to not work.
For a great many diseases there are no treatments that will actually cure and everyone knows that.
You keep setting up strawmen while ignoring the real choices that exist today. Yes, there are lots of experimental therapies. Yes, there are lots of terminally ill patients who know the experimental therapies really are unproven. They really are willing to gamble their remaining short numbers of days in hopes of getting a longer life or at least providing evidence about experimental therapies. That is not the strawman case. That is the real case and you ignore it.
There are many possible scenarios and mine is one and it is a valid scenario that illustrates why some regulation is appropriate even for terminally ill patients. Do you advocate that the folks who pretend to pull chicken guts out of desparate cancer patients be allowed to practice their "medicine" in the US? You don't keep a police force for the law abiding, you keep it for the criminals. A small percentage of the populace are criminals and the ones that are need to be controlled. In my post of March 4 I addressed the cases of legitimate, promising but unproven therapies so please don't lie and say I didn't! You are clearly guilty of not addressing the many key points that I made regarding informed consent and how consumers can make reasonable determinations about drugs if there isn't legitimate, independent research and disclosure.
Furthermore, your tactic of misrepresenting my position and then declaring victory is the sleaziest of debating tactics and I WILL call you on it.
"You don't keep a police force for the law abiding, you keep it for the criminals. A small percentage of the populace are criminals and the ones that are need to be controlled."
But the current system controls everyone, before the fact, and forbids consumers to make their own decisions about the risks they will take. An FDA that only required publicly available testing information on drugs would be many orders of magnitude better than what we have now. An FDA that forbids customers from taking risks on the basis of valid data, even risks that are less than the risks they face without treatment, has no legitimate place in a free society.
"Some liberties are not consistent with a just civilization and amoung those are pharmaceudical companies' right to sell lethal drugs and your right to rob a bank. Any questions?"
Yes. How in the Hell are the two examples even related? In a just civilization, we would be allowed to not only buy dangerous drugs (the only kind that exist, when you get right down to it), but drugs that we knew damn well were 100% lethal, and use them as we saw fit. In a just civilization, the problem of crooks ripping people off and fraudulently selling crap would be dealt with by the criminal justice system after the fact, while the majority of decent people were allowed to work and compete unmolested. And yes, I am saying that the crooks should be dealt with after they kill people, rather than deprive everyone of their liberties just because a few will misuse them. After all, thugs kill people all the time on the street, and are only dealt with after the fact - why treat the vendors of medicine worse than that?
Again, suppose the person getting the unproven therapy is told it is unproven. Suppose they are told it is experimental. Why should they be denied its use? If one has 3 months left to live and there is an anti-angiogenesis compound that hasn't even been tried yet in humans but was just discovered to be an anti-angiogenesis compound in Judah Folkman's lab at Harvard then why shouldn't that cancer patient be able to try it?
Oh, and I am not misrepresenting your position. If you want to posture as morally indignant you can but it will have no effect on my responses.
"After all, thugs kill people all the time on the street, and are only dealt with after the fact - why treat the vendors of medicine worse than that?"
You clearly don't know much about the justice system. How long we keep people in jail has everything to do with how violent we expect that person to be in the future. The justice system ALWAYS seeks to prevent the deaths of innocent people as do all rational and moral people. But apparently not radical ideologues.
"How in the Hell are the two examples even related? "
They are both illegal and should be, and they both are examples of criminals depriving people of their rights and liberties. Dead people are in a permanent state of "non-freedom" and that should be avoided if it is reasonably practical. Most people would avoid things that cause their deaths, like taking drugs that are 100% lethal. Of course that would not include radical ideologues such as yourself. Most of the activity of the FDA has to do with determining the efficacy and safety of drugs. I am glad to see that you have finally admitted that that is a reasonable thing for a federal agency to do. It is not true that the FDA prohibits the sale of drugs that can kill you. What they reasonably prohibit (or should prohibit) are drugs that are clearly more harmful than good based on scientific testing. In the case of Vioxx, for example, it is no more effective than generic naproxen in terms of pain relief but it gives tens of thousands of people fatal heart attacks. Society does not need a drug like that and it is reasonable to prohibit dangerous drugs that do no good. If we can prevent the deaths of tens of thousands of innocent citizens by reasonable, cost effective research, why wouldn't we? Correct me if I'm wrong, but logically you would support the "rights" of hillbillys in trailers making meth and selling it to drug addicts as long as the resulting deaths were not "intentional". Most rational people recognize that meth is a dangerous drug that does no good and is very dangerous and is therefore a net harm to society and should reasonably be prohibited. Too bad about the rights of the meth addict to get high.
"Again, suppose the person getting the unproven therapy is told it is unproven. Suppose they are told it is experimental. Why should they be denied its use?"
Again, that is clearly misrepresenting my position. I previously pointed out that I had discussed the problems of drugs for the terminally ill on the 4th. Since you don't seem willing to check what I actually said, I copy it here:
"Without question, drugs for terminal conditions should have different testing schedules than run-of-the-mill drugs/conditions. The cost/benefit of all regulatory activity should be monitored and analyzed continuously. If it is doing more harm than good it should be altered. I doubt we disagree about that. It does seem reasonable to try to make trials of experimental drugs as widely available as is reasonable based on the details of the protocol for the experiment."
Of course I don't expect the facts to affect your responses. Facts rarely affect blindered idealogues.
So if I do not accept the moral assumptions of the regulatory nanny state then I'm an ideologue?
Look, our disagreement is about ethics and rights. I think a person's right to control their own body should extend to the point that when faced with a fatal disease the person should have the absolute right to try any experimental therapies. I do not think that right should be abridgeable by the FDA. It is not a misrepresentation of your position to state that you do not recognize such a right on the part of the patient.
Again, you have not answered my question on a moral level. You simply state that the FDA should have the power to decide whether, in the estimation the FDA, the cost/benefit is expected to be unfavorable to patient. Yes, you'd like experimental treatments to be more widely available. But that is not going to happen as long as the FDA has the amount of power it currently has.
Case in point: EntreMed ran out of money to continue a trial for an anti-angiogenesis drug which had a slow mechanism of action (and all anti-angiogenesis drugs work slowly and do not fit the FDA model for judging efficacy of anti-cancer drugs - this is an obvious sore point with Judah Folkman). Cancer patients on the drug who were alive years longer than expected given their diagnoses said they'd willingly pay the cost of drug production to continue getting the drugs. But the company was not allowed by the FDA to sell unapproved drugs if the company could not contimue a formal trial with all testing and record keeping and document filing that entailed. So patients will die.
I see that in spite of everyone's best efforts, you have managed to completely hijack and derail this thread of discussion.
If I am the person not listening, why are you the one responding to the point that the FDA has been approving deadly drugs for several decades with allegations of causality from political events of recent years. I don't have time to dig up the figures for something that is in the end beside the point, but the FDA has been approving drugs that kill people for decades.
And when it comes to COX2 inhibitors like VIOXX, they actually provide a tremendous benefit to a large segment of the patient base they treat. Admissions for aspirin induced stomach bleeding and ulceration are way way down. The current problem results from the fact that a significant minority have a genotype or genotypes rendering the drug fatal. A responsible organization, instead of putting an outright ban on the drug, would communicate the risks to the affected public and encourage the development of an effective screening protocol.
And yes, that screening protocol would necessarily involve genetic screening. It might advance the technology or reduce the cost of microfluidics, gene arrays or a whole host of other enabling technologies.
None of your blather about accusing people of ideological blindness addresses the root point about market rewards for certain kinds of science or the ensuing public benefit. Having known Randall for well over a decade now, I can say without question that I know of no human being less bound by ideology than Randall G. Parker.
When you accuse Randall of ideological blindness, all I can think is "This nutcase projects his own character defects onto everyone he meets."
"Look, our disagreement is about ethics and rights. I think a person's right to control their own body should extend to the point that when faced with a fatal disease the person should have the absolute right to try any experimental therapies."
It seems more likely that our disagreement has to do with your use of the term "absolute right" and my use of the term "reasonable". I would argue that there is no such thing as an "absolute right" and it is your use of terms like that that identifies you as an ideologue. Even the right to life can be abridged by the state under extreme circumstances (although I am not personally in favor of the death penalty). Firstly, and on numerous occasions I made the point that without valid, independent and unbiased research on the efficacy and safety of drugs consumers or physicians cannot make a rational and informed decision on the use or choice of drugs. Secondly, it is my position that it is reasonable for the government to provide this information in service to the general well-being of the public. No one has effectively countered this point. Obviously, the provision of that information is not going to guarantee that people make rational decisions based on it, but they clearly could not do so without it. Now a logical interpretation of "absolute right to try any experimental therapies" would include examples I already gave and you called straw men, like con men pretending to pull chicken guts out of cancer patients. I could call that an experimental therapy on the basis that one's state of belief and optimism may have an effect on the immune system. But in reality it is a con man's scam and the con man should not be permitted to prey on the desperation of the terminally ill. That is an ethical judgement that I think most rational citizens share. Your use of the phrase "absolute right to try any experimental therapies" clearly and absolutely indicates that you put the rights of the con man and the "rights" of the patient to be conned ahead of the well being and life of the patient. You cannot argue that if it weren't prohibited, con men wouldn't con the desperate and thousands would lose their money and die rather than seek legitimate treatment. That is not a good result for the public and it is reasonable for the government to protect people from con men in the health field just as it is in the used car field. Somehow society has to decide what is a con game therapy and what is a legitimate experimental therapy and that is why we have the FDA doing experiments. You would prefer the deaths of thousands because of an ideological distaste for government regulation however reasonable, which is in reality the rule of law applied to corporations. That is why I can call you an ideologue. I have no problem with people trying experimental drugs, but their use should be based on reasonable and rational principles of science and con men should be excluded. What is "reasonable and rational"? That is what society has to decide and implement through the rule of law.
In the same way, I would maintain that it is reasonable for the governement to make decisions regarding whether certain drugs cause more harm than good to society. In my well used example of Vioxx, the efficacy of the drug was overstated and it's danger was understated in marketing literature. It was not tested in a way to determine it's problems with respect to heart problems because the rules were ineffective largely because of pharmaceudical industry lobbying to reduce those costs. As a direct result, the best scientific estimates are that 55,000 innocent citizens are now dead. That is a horrendously bad result morally and as I pointed out before, by reasonable actuarial accounting, cost our society $110 billion, enough to pay for the budget of the FDA for over sixty years. Thus it is REASONABLE for the FDA to do it's job and do it correctly because with a small amount of additional testing those people would be alive. I look at reasonable results and saving the lives of 55,000 people by taking reasonable, highly cost effective precautions is a good result, recognized as such by all but severely disabled schizophrenics and absolutist ideologues.
With regard to the EntreMed situation, as I clearly stated before, if regulatory activity is leading to more harmful results than good results, it should be altered, taking into consideration the special circumstances of terminal disease. That can be accomplished in this case without eliminating the FDA.
"I see that in spite of everyone's best efforts, you have managed to completely hijack and derail this thread of discussion."
That is an outrageous and false accusation. I am the only one who has made any effort at all to get it back on subject, as I pointedly noted in my last post to you. And in that post I invited you directly to comment on the question of science in the public interest. Did you do so? No, you respond by calling me names. Why didn't you make any statements about the subject that you repeatedly say is so important? From what I can tell, you can't. So who is blathering? I am the only contributor here who has been making cogent and coherent arguments to support my position. When Randall uses radical right-wing, laissez faire buzz words like "regulatory nanny state" he is talking like an ideologue and he has consistently mischaracterised my position rather than making a coherent counter argument. When he stops talking and acting like an ideologue maybe I might believe your stated opinion. I seriously doubt your judgement on the topic in any case.
"A responsible organization, instead of putting an outright ban on the drug, would communicate the risks to the affected public and encourage the development of an effective screening protocol."
It turns out that with the other COX2 inhibitors on the market, that is what the FDA chose to do. So you would seem to support the contention that the FDA is a "responsible organization". I'm not sure I would go that far, but I believe that with sufficient public outrage at the Vioxx fiasco, it could be.
When you begin to make coherent arguments to support your position then you can consider criticizing me. Until that time, keep your childish name calling to yourself.
As for the supposed $110 billion in damage from Vioxx: It rests on the assumption that the alternative NSAIDs that are not specifically Cox2 inhibitors do not all have a similar effect on mortality. But the FDA's own experts who you place so much faith in have stated in public hearings (I saw this on C-SPAN a month ago) that they do not know whether some of the other NSAIDs have similar effects because the older NSAIDs have not been as well tested as the newer Cox2 inhibitors. The Vioxx result was found only because lots of longer term studies were done on it.
An absolute right to try any therapy would certainly include therapies that would be net harms. It would also include therapies that would be net benefits that are currently not available for a variety of reasons (e.g. drugs that are off patent for which there is little incentive to do the needed trials to check for efficacy and drugs whose owning companies see too small a market for a drug to warrant an investment). But that is besides the point. Do we own our own bodies or not? Should not a person with a short period left to live be able to gamble on unproven therapies? What if the person does not want the protection of the state? You insist on imposing it upon him even though he doesn't want it.
As for eliminating the FDA: We could have far greater freedom to control our own treatment without eliminating the FDA. Drugs that are approved by the FDA could be advertised as such and any drugs that are not FDA approved could require patient notification and explicit patient approval before use. So anyone who wants the FDA's approval on treatments could have it and anyone who doesn't want it could go without it. I think the argument for letting people opt out of FDA regulatory reach is especially compelling for people who are going to die and who are in terrible suffering who have little left to lose.
You have decided what is reasonable and you have decided what is morally acceptable and anyone who advocates a different standard you call an ideologue. You have your values and seek to impose them on the public.
I really see no point in continuing this discussion.
"I really see no point in continuing this discussion."
Fine, then I shall have the last word.
Let me say that the scientific and testing issues surrounding Vioxx are very complex. It appears to me that there is not very good standard practice with regard to the testing, and it is difficult to relate one test's results with anothers. Having said that it seems like a reasonable thing to do to remove Vioxx from the market. Since the manufacturer voluntarily removed it before the FDA could act it seems unlikely that there is much dispute that it was a drug with net negative effects. Obviously the $110 billion number is a gross estimate and the exact numbers of deaths that can reasonably be attributed to the drug cannot be known precisely. The main point is that it is reasonable to seek to prevent unnecessary deaths and that such an effort is cost effective to society.
Let me include these exerpts from the Chicago Tribune, Published February 10, 2005:
More than two years before Merck & Co. pulled the popular painkiller Vioxx from the market over safety concerns, federal regulators knew studies had indicated older people taking the drug were more likely to die than those in a placebo group.
Despite receiving this information from two studies involving Alzheimer's patients, the Food and Drug Administration did not require the company to warn physicians of the spike in deaths in older Vioxx users.
Nor did the drug company publicize the results of the studies it conducted, which were preliminary but raised a red flag about Vioxx's safety.
Singh had previously reported that Merck executives threatened him when he raised questions about whether the company was disclosing all relevant data about Vioxx.
"These studies show a substantial increase in mortality associated with Vioxx," said Dr. Curt Furberg.
Late last year, Furberg said an FDA official asked him not to participate in the committee's meetings on painkillers after expressing concerns about a medication similar to Vioxx--Bextra, made by Pfizer Inc.
Though these side effects occur with many painkillers, a note in the Alzheimer's study indicates that Vioxx caused a "two- to threefold increase in the incidence of hypertension-related events as compared to naproxen," a common pain reliever often sold as Aleve.
When VIGOR in 2000 showed a fivefold increase in heart attacks for patients taking Vioxx, the FDA and Merck decided to look at the company's Alzheimer's studies to see what light they could shed on Vioxx's safety. (END)
I think that shows that there was a very strong risk to the drug, that Merck threatened people in trying to cover up that risk and that the FDA actually supported those efforts at concealment. The FDA officials that sought to conceal the test results were ex-industry appointees, working on behalf of the industry even though they should have been protecting the interests and health of the public. Your statement about the testing of older NSAIDs doesn't make much sense to me, based on what I've read. And who told you that "I put so much faith in" FDA experts? My faith lies in well designed, unbiased scientific research and I have made that abundantly clear. If such research shows a definite benefit and an acceptable risk for Vioxx for an identifiable population, then sell the stuff to them.
"An absolute right to try any therapy would certainly include therapies that would be net harms." Not in question. What I asked was "Does it include obviously harmful or ineffective (or both) medicines that are sold by con men and charlatans?" That is not a "straw man" as you claim, it is a real issue for society to deal with and it was a real reason for the establishment of the FDA. Ken has at least clearly stated his opinion that corporations should be allowed to kill thousands of people for the sake of the sacred free market. Do you support the rights of charlatans and con men to prey on the deserately ill or not? To me your term "absolute" clearly says you do, so you needn't answer. I would submit that is a very radical and amoral position supported only by ideology.
"What if the person does not want the protection of the state? You insist on imposing it upon him even though he doesn't want it."
Do you get to choose not to be protected from murderers and robbers and rapists? That protection is provided by the state via the police whether or not you think you need it, because the government and the public "ruled by consent" has decided those crimes are harmful to the general welfare of the public. I think the vast majority of people would agree that charlatans and con men preying on the desperately ill belongs in the same category of criminal behavior. I would further propose that grossly negligent and deceptive behavior on the part of corporations that results in thousands of deaths would also be considered by the vast majority of the population to be criminal. I have to believe that you don't. By my way of thinking, that puts you way out on the ideological fringe. I am not imposing my values on the public, it is the public itself, by consenting to be governed by the rule of law rather than the law of the jungle, that imposes values. And that is a wholly good thing, as Tom Jefferson clearly said.