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The state telling people they have to be blind or move to a different country is unquestionably controlling their bodies. The FDA kills thousands of people by n

The state telling people they have to be blind or move to a different country is unquestionably controlling their bodies. The FDA kills thousands of people by not letting them access drugs and medical devices. I cannot understand wanting more of that. Even if we ignore the consequences, it's simply wrong for anyone to override a consenting adult's choices over their body. It doesn't matter if it's about implants, drugs, abortions, carcinogens, etc.

torben-friis 4y ago
> Even if we ignore the consequences, it's simply wrong for anyone to override a consenting adult's choices over their body. It is a pretty evident fact that, in the modern world, a person can not possibly have enough knowledge, understanding, and available time to make enough informed choices for their own survival. Quick! you're in a shop looking for shampoo and it contains ammonium lauryl sulfate. Is it a valid surfactant, or a ticket to an early grave? No idea? Tough luck buddy. What I described above is not an absurd exaggeration, is the world we once lived in. See https://en.wikipedia.org/wiki/William_J._A._Bailey https://en.wikipedia.org/wiki/William_J._A._Bailey Behind the tempting ideal of personal responsibility lies the flip side of leaving people unarmed and open to manipulation. Everything has tradeoffs, and our system might harm some people when access to reviewed products doesn't come soon enough for them. This damage is far counterweighted by not having your daughter's jaw fall off because she chose the wrong brand of lipstick.
- 9864250 4y ago
  That's frankly a ridiculous straw man. A person can likewise not have enough knowledge, understanding, or time to make informed choices for other's survival. The difference is that when someone makes the wrong choice about their own survival, they die. When someone makes the wrong choice about other people's survival, other people die. Nobody is arguing against listening to experts or using processes to make safety decisions. I'm just saying that you should not enforce your judgement on other people. I don't object to the state or anyone else making recommendations or to other people following them. Everyone is ultimately responsible for deciding whom to trust. If you trust the state, you should be free to defer to their judgement, as you will be the one to pay the ultimate price if you are wrong. If I trust some other organization, I should be free to do the same. The state's ability to enforce its judgement by means of violence doesn't make it more likely to be correct. Might dosen't make right when it comes to science or individual trade-offs. If I'm in the shop buying shampoo, I can look for the name or logo of an organization that I trust to determine the safety of products. If I need a medical product that the FDA has not approved, and I'm unable to travel aboard? What I'm I supposed to do? Die like thousands of people before me[0]? Is that just "Tough luck buddy" to you because your ideology is more important than my life and freedom? [0]: https://www.cato.org/commentary/end-fda-drug-monopoly-let-patients-choose-their-medicines# https://www.cato.org/commentary/end-fda-drug-monopoly-let-pa...
  - torben-friis 4y ago
    >A person can likewise not have enough knowledge, understanding, or time to make informed choices for other's survival. Sure, but surely you'll agree that a body of experts trained and given full time dedication to make the choice will make better decisions than an average person encountering the problem without previous preparation. > If you trust the state, you should be free to defer to their judgement, as you will be the one to pay the ultimate price if you are wrong. If I trust some other organization, I should be free to do the same. That brings us back to the original situation, with extra steps. Being unable to make informed choices includes being unable to choose the right source of truth to delegate your choices to. People that can't tell the difference between psychology and psychoanalysis won't be qualified to choose between believing a psychologist or a psychoanalyst either. > The state's ability to enforce its judgement by means of violence doesn't make it more likely to be correct. The defining characteristic of the state in this situation is not its monopoly on violence, it's its nature of representing the collective will and interest of the people. A state agency that regulates products is not created to be profitable nor to have any interest other than the wellbeing of the people it represents. > If I need a medical product that the FDA has not approved, and I'm unable to travel aboard? What I'm I supposed to do? Die like thousands of people before me[0]? Is that just "Tough luck buddy" to you because your ideology is more important than my life and freedom? It is not a matter of ideology. It is a matter of tradeoffs. The situation you describe is not strictly impossible, but the number of times a person is able to correctly diagnose its own needs and how to solve them better than a whole professional system is a rounding error, compared to the amount of times people will be harmed by incorrectly believing they know better. Since no system can't solve both of those problems, you have to choose the lesser evil. You choose to identify more with the person who correctly knows what he needs, rather than with the person that in desperation is fooled into believing an incorrect 'expert'. That's understandable, but its human bias, and you're statistically far, far, far more likely to be the second than the first.
    - 9864250 4y ago
      Sure, a group of experts is generally more likely to make a good decision when an objectivity good decision can be made (which is often not the case because individual preferences vary). If however, that group is able to enforce its will by violence, it will probably make worse decisions because it has no incentives to make good decisions, and corruption can give it incentives to make bad ones. The defining characteristic of the state in this situation is undoubtably it's capacity for violence. That is what creates the entire situation. If it were not for the state's superior capacity for violence, it would not be able to enforce its decisions by violence, and everyone would be free to decided whom to trust. To describe the state as "representing the collective will and interest of the people" is simply incorrect. Even if the state represented the will of the majority, it would be wrong to equate the majority of people who live in a particular place with all the people who live in that place. Just as might doesn't make right, neither does being more numerous. In reality, the state doesn't even represent the interest of the majority of people, but only a tiny fraction of people with sufficient wealth to lobby effectively. Even if you had a hypothetical state that only existent to enforce the will of the many on the few, such a state would probably be wrong more often than an individual because while the wisdom of the crowd can work, it can be easily undermined under conditions I think would be inevitable in such a scenario[0]. A million people who can't tell the difference between psychology and psychoanalysis won't be able to choose between electing a psychologist or a psychoanalyst, any more than they can choose between believing a psychologist or a psychoanalyst. The only difference is that under the majoritarian model, everyone is forced to accept the choice of the majority. The situation I described happens all the time. It's the rule, not an exception. The link I posted includes several examples. The FDA has become a little better in the last few years, but it continues to kill people by refusing to allow them access to drugs and medical devices. Here is a more recent article specifically about the delay in approving the covid vaccines: https://www.theatlantic.com/ideas/archive/2021/08/fda-delays-carry-death-toll/619871/ https://www.theatlantic.com/ideas/archive/2021/08/fda-delays... This is not primarily about people who diagnose themselves, although they should have the right to do that as well. It's about people who are diagnosed by a doctor who knows how to help them, but would go to prison if they tried. Often the drug has been used in other countries for years, and the company has simply not paid the FDAs exorbitant licence fees. One example from the link I posted in an earlier comment: > Pharmacologist William Wardell concluded that the five year delay in allowing the hypnotic Nitrazepam to be used in America (after Britain’s approval) cost 3,700 lives. He believed that the FDA also cost thousands of lives by preventing the sale of the first beta‐ blocker Propranolol for three years after it was available in Europe, and another seven years before it could be used for its most useful purposes. Sam Kazman of the Competitive Enterprise Institute (CEI) figured the annual beta‐ blocker toll at 17,000. Overall, he wrote, “as many as 100,000 people may have died waiting for FDA to act.” [0]: https://www.pnas.org/doi/pdf/10.1073/pnas.1008636108 https://www.pnas.org/doi/pdf/10.1073/pnas.1008636108
Volundr 4y ago
> The FDA kills thousands of people by not letting them access drugs and medical devices. How many lives has the FDA saved by not allowing companies to use the public as human guinea pigs, or present a product as beneficial if when the evidence is clearly in that it is dangerous and harmful? I don't claim the FDA is perfect, but frankly if you want to reform agencies causing pain, suffering and death by refusing access to treatments, we should deal with insurance companies long before worrying about the FDA.
- 9864250 4y ago
  I don't think the FDA has saved nearly as many people as it has killed, but it's going to be impossible to get good statistics on either variable. "Saving" someone against their will is not a good thing, so even if the FDA had saved more people than it killed, it wouldn't justify its coercive powers. I agree that the medical insurance industry in the US is extremely dysfunctional (in large part because of regulations), but people have much more recourse when they are harmed by an insurance company compared to a government agency. I doubt more people die as a result of insurance companies decisions compared to the FDA's decisions. I can't find a good estimate for the number of deaths caused by insurance companies, one study from 2009 estimated 45,000 deaths annually linked to lack of health coverage in the US (these would be more comparable to those who die because of the FDA because they similarly lack recourse)[0], this is probably much lower than the FDA's death toll. FDA was also likely a contributing factor in the deaths of many of those who died due to lack of health coverage because the FDA's licencing costs and the slow and arbitrary way it processes applications are a significant reason for the high drug prices in the US. [0]: https://news.harvard.edu/gazette/story/2009/09/new-study-finds-45000-deaths-annually-linked-to-lack-of-health-coverage/ https://news.harvard.edu/gazette/story/2009/09/new-study-fin...
  - Volundr 4y ago
    > "Saving" someone against their will is not a good thing, so even if the FDA had saved more people than it killed, it wouldn't justify its coercive powers Is it against their will though? People want someone making sure pharmaceuticals and other medical companies aren't doing dangerous things. That's why the FDA was created. People forget that most of these agencies like the FDA and EPA weren't created out of thin air, they were addressing real problems affecting real people. > but people have much more recourse when they are harmed by an insurance company compared to a government agency Strongly disagree based on real life experience. If the FDA is blocking some life saving treatment do due to unnecessary red tape I can harass my congressman or senator. Oh sure if it's just me they probably won't care unless my story is particularly poignant, but get a few people writing them and they'll take notice (seriously people underestimate how important writing your representatives is). My insurance company doesn't give a shit. My sister has severe MS. Her doctor prescribed a medication meant for people like her, her insurance company said no, they wanted her on a different medication that had never been studied for MS, much less approved. She appealed, the insurance company denied the appeal. The hospital appealed twice, denied both times. A lawyer advised there wasn't much point in fighting further. There's no recourse against the insurance company beyond being sufficiently wealthy to either not need them, or challenge their lawyers. I trend pretty libertarian when it comes to people dealing with their own bodies. Want to drink formaldehyde because you think it'll cure your cancer? You do you. But if a company wants to sell it as a cure they should have to do some bare minimum of testing to ensure it works and won't just give you more cancer. That's the FDAs job.

torben-friis 4y ago

> Even if we ignore the consequences, it's simply wrong for anyone to override a consenting adult's choices over their body. It is a pretty evident fact that, in the modern world, a person can not possibly have enough knowledge, understanding, and available time to make enough informed choices for their own survival. Quick! you're in a shop looking for shampoo and it contains ammonium lauryl sulfate. Is it a valid surfactant, or a ticket to an early grave? No idea? Tough luck buddy. What I described above is not an absurd exaggeration, is the world we once lived in. See https://en.wikipedia.org/wiki/William_J._A._Bailey https://en.wikipedia.org/wiki/William_J._A._Bailey Behind the tempting ideal of personal responsibility lies the flip side of leaving people unarmed and open to manipulation. Everything has tradeoffs, and our system might harm some people when access to reviewed products doesn't come soon enough for them. This damage is far counterweighted by not having your daughter's jaw fall off because she chose the wrong brand of lipstick.

9864250 4y ago
That's frankly a ridiculous straw man. A person can likewise not have enough knowledge, understanding, or time to make informed choices for other's survival. The difference is that when someone makes the wrong choice about their own survival, they die. When someone makes the wrong choice about other people's survival, other people die. Nobody is arguing against listening to experts or using processes to make safety decisions. I'm just saying that you should not enforce your judgement on other people. I don't object to the state or anyone else making recommendations or to other people following them. Everyone is ultimately responsible for deciding whom to trust. If you trust the state, you should be free to defer to their judgement, as you will be the one to pay the ultimate price if you are wrong. If I trust some other organization, I should be free to do the same. The state's ability to enforce its judgement by means of violence doesn't make it more likely to be correct. Might dosen't make right when it comes to science or individual trade-offs. If I'm in the shop buying shampoo, I can look for the name or logo of an organization that I trust to determine the safety of products. If I need a medical product that the FDA has not approved, and I'm unable to travel aboard? What I'm I supposed to do? Die like thousands of people before me[0]? Is that just "Tough luck buddy" to you because your ideology is more important than my life and freedom? [0]: https://www.cato.org/commentary/end-fda-drug-monopoly-let-patients-choose-their-medicines# https://www.cato.org/commentary/end-fda-drug-monopoly-let-pa...
- torben-friis 4y ago
  >A person can likewise not have enough knowledge, understanding, or time to make informed choices for other's survival. Sure, but surely you'll agree that a body of experts trained and given full time dedication to make the choice will make better decisions than an average person encountering the problem without previous preparation. > If you trust the state, you should be free to defer to their judgement, as you will be the one to pay the ultimate price if you are wrong. If I trust some other organization, I should be free to do the same. That brings us back to the original situation, with extra steps. Being unable to make informed choices includes being unable to choose the right source of truth to delegate your choices to. People that can't tell the difference between psychology and psychoanalysis won't be qualified to choose between believing a psychologist or a psychoanalyst either. > The state's ability to enforce its judgement by means of violence doesn't make it more likely to be correct. The defining characteristic of the state in this situation is not its monopoly on violence, it's its nature of representing the collective will and interest of the people. A state agency that regulates products is not created to be profitable nor to have any interest other than the wellbeing of the people it represents. > If I need a medical product that the FDA has not approved, and I'm unable to travel aboard? What I'm I supposed to do? Die like thousands of people before me[0]? Is that just "Tough luck buddy" to you because your ideology is more important than my life and freedom? It is not a matter of ideology. It is a matter of tradeoffs. The situation you describe is not strictly impossible, but the number of times a person is able to correctly diagnose its own needs and how to solve them better than a whole professional system is a rounding error, compared to the amount of times people will be harmed by incorrectly believing they know better. Since no system can't solve both of those problems, you have to choose the lesser evil. You choose to identify more with the person who correctly knows what he needs, rather than with the person that in desperation is fooled into believing an incorrect 'expert'. That's understandable, but its human bias, and you're statistically far, far, far more likely to be the second than the first.
  - 9864250 4y ago
    Sure, a group of experts is generally more likely to make a good decision when an objectivity good decision can be made (which is often not the case because individual preferences vary). If however, that group is able to enforce its will by violence, it will probably make worse decisions because it has no incentives to make good decisions, and corruption can give it incentives to make bad ones. The defining characteristic of the state in this situation is undoubtably it's capacity for violence. That is what creates the entire situation. If it were not for the state's superior capacity for violence, it would not be able to enforce its decisions by violence, and everyone would be free to decided whom to trust. To describe the state as "representing the collective will and interest of the people" is simply incorrect. Even if the state represented the will of the majority, it would be wrong to equate the majority of people who live in a particular place with all the people who live in that place. Just as might doesn't make right, neither does being more numerous. In reality, the state doesn't even represent the interest of the majority of people, but only a tiny fraction of people with sufficient wealth to lobby effectively. Even if you had a hypothetical state that only existent to enforce the will of the many on the few, such a state would probably be wrong more often than an individual because while the wisdom of the crowd can work, it can be easily undermined under conditions I think would be inevitable in such a scenario[0]. A million people who can't tell the difference between psychology and psychoanalysis won't be able to choose between electing a psychologist or a psychoanalyst, any more than they can choose between believing a psychologist or a psychoanalyst. The only difference is that under the majoritarian model, everyone is forced to accept the choice of the majority. The situation I described happens all the time. It's the rule, not an exception. The link I posted includes several examples. The FDA has become a little better in the last few years, but it continues to kill people by refusing to allow them access to drugs and medical devices. Here is a more recent article specifically about the delay in approving the covid vaccines: https://www.theatlantic.com/ideas/archive/2021/08/fda-delays-carry-death-toll/619871/ https://www.theatlantic.com/ideas/archive/2021/08/fda-delays... This is not primarily about people who diagnose themselves, although they should have the right to do that as well. It's about people who are diagnosed by a doctor who knows how to help them, but would go to prison if they tried. Often the drug has been used in other countries for years, and the company has simply not paid the FDAs exorbitant licence fees. One example from the link I posted in an earlier comment: > Pharmacologist William Wardell concluded that the five year delay in allowing the hypnotic Nitrazepam to be used in America (after Britain’s approval) cost 3,700 lives. He believed that the FDA also cost thousands of lives by preventing the sale of the first beta‐ blocker Propranolol for three years after it was available in Europe, and another seven years before it could be used for its most useful purposes. Sam Kazman of the Competitive Enterprise Institute (CEI) figured the annual beta‐ blocker toll at 17,000. Overall, he wrote, “as many as 100,000 people may have died waiting for FDA to act.” [0]: https://www.pnas.org/doi/pdf/10.1073/pnas.1008636108 https://www.pnas.org/doi/pdf/10.1073/pnas.1008636108

Volundr 4y ago

> The FDA kills thousands of people by not letting them access drugs and medical devices. How many lives has the FDA saved by not allowing companies to use the public as human guinea pigs, or present a product as beneficial if when the evidence is clearly in that it is dangerous and harmful? I don't claim the FDA is perfect, but frankly if you want to reform agencies causing pain, suffering and death by refusing access to treatments, we should deal with insurance companies long before worrying about the FDA.

9864250 4y ago
I don't think the FDA has saved nearly as many people as it has killed, but it's going to be impossible to get good statistics on either variable. "Saving" someone against their will is not a good thing, so even if the FDA had saved more people than it killed, it wouldn't justify its coercive powers. I agree that the medical insurance industry in the US is extremely dysfunctional (in large part because of regulations), but people have much more recourse when they are harmed by an insurance company compared to a government agency. I doubt more people die as a result of insurance companies decisions compared to the FDA's decisions. I can't find a good estimate for the number of deaths caused by insurance companies, one study from 2009 estimated 45,000 deaths annually linked to lack of health coverage in the US (these would be more comparable to those who die because of the FDA because they similarly lack recourse)[0], this is probably much lower than the FDA's death toll. FDA was also likely a contributing factor in the deaths of many of those who died due to lack of health coverage because the FDA's licencing costs and the slow and arbitrary way it processes applications are a significant reason for the high drug prices in the US. [0]: https://news.harvard.edu/gazette/story/2009/09/new-study-finds-45000-deaths-annually-linked-to-lack-of-health-coverage/ https://news.harvard.edu/gazette/story/2009/09/new-study-fin...
- Volundr 4y ago
  > "Saving" someone against their will is not a good thing, so even if the FDA had saved more people than it killed, it wouldn't justify its coercive powers Is it against their will though? People want someone making sure pharmaceuticals and other medical companies aren't doing dangerous things. That's why the FDA was created. People forget that most of these agencies like the FDA and EPA weren't created out of thin air, they were addressing real problems affecting real people. > but people have much more recourse when they are harmed by an insurance company compared to a government agency Strongly disagree based on real life experience. If the FDA is blocking some life saving treatment do due to unnecessary red tape I can harass my congressman or senator. Oh sure if it's just me they probably won't care unless my story is particularly poignant, but get a few people writing them and they'll take notice (seriously people underestimate how important writing your representatives is). My insurance company doesn't give a shit. My sister has severe MS. Her doctor prescribed a medication meant for people like her, her insurance company said no, they wanted her on a different medication that had never been studied for MS, much less approved. She appealed, the insurance company denied the appeal. The hospital appealed twice, denied both times. A lawyer advised there wasn't much point in fighting further. There's no recourse against the insurance company beyond being sufficiently wealthy to either not need them, or challenge their lawyers. I trend pretty libertarian when it comes to people dealing with their own bodies. Want to drink formaldehyde because you think it'll cure your cancer? You do you. But if a company wants to sell it as a cure they should have to do some bare minimum of testing to ensure it works and won't just give you more cancer. That's the FDAs job.