28 December
2004
Thomas Sowell
http://www.NewsAndOpinion.com
| In
the midst of all the alarms being sounded about the health risks from taking
Vioxx and Celebrex, there is a story about National Football League players
using less padding than in the past. What is the connection?
The NFL players know that padding
gives some protection against injuries — but at a price. Carrying the extra
weight of padding around slows players down, making them less effective on the
football field and perhaps less able to quickly get out of the way of tackles
and collisions. In short, they understand that safety is not a free lunch but
something you have to pay for, in one way or another.
Most players wear some padding,
just not as much as they are allowed to, or as much as their teams make
available to them. In short, NFL players recognize a trade-off, as most other
people do in most other aspects of life.
Where do people not recognize
trade-offs? Where they are making decisions for other people. That's where they
make unrealistic demands, including demands for "safety."
Maybe Vioxx or Celebrex is too
dangerous, all things considered. Maybe not. The problem is that all things are
not considered.
Too many people seem to think that
if the risk of stroke or heart attack is doubled when you take some medication,
that is the end of the story. But they would never apply such reasoning to
practical decisions in their own lives.
Suppose you learned that the risk
of being killed in an automobile accident doubled if you drove to work on the
highway instead of driving through the city streets. What if the odds that you
would be killed driving to work every day on the highway were one in a million,
while the risk of being killed driving to work on the streets were one in two
million?
And what if it took you 15 minutes
to get to work on the highway and an hour driving through city traffic?
Some cautious people might prefer
driving to work on the streets while other people would take the highway.
Regardless of which group was larger, the point is that each individual could
make the trade-offs when the facts were known. But that is not the way
decisions are made, or even advocated, when there are "safety"
issues, including issues about drugs like Vioxx and Celebrex.
Studies indicate that the great
majority of people taking even heavy doses of these drugs over an extended
period of time did not have either a stroke or a heart attack. However, the
small number of people who did was greater than among those who did not take
these drugs.
Obviously people would not be
taking these or other medications unless they had a problem that these drugs
were intended to help. The question then is whether the benefits exceed the
costs or vice-versa.
This is a medical decision which
can vary from patient to patient. Doctors are there to advise about these
things, since these are prescription drugs — not something that a layman can
pick up off a counter at the local drugstore.
But that is not good enough for
"safety" advocates, many of whom have no medical training. If a drug
is not "safe," they say it should not be allowed on the market. But
nothing is categorically safe.
Some people can die from eating
ordinary wholesome foods like salmon or peanut butter. If the government banned
every food that was fatal to someone, we might all die of malnutrition.
If a drug is not safe, neither is
the illness for which the drug is prescribed. Nor are alternative drugs likely
to be perfectly safe, since nothing else is. Life involves weighing alternative
risks, whether in football, pharmaceutical drugs, or a thousand other things.
Politically, it is always easy to
be on the side of the angels with ringing pronouncements about making sure our
medicines are safe. Ideologues are in their glory denouncing "corporate
greed" among drug companies. But ideology never cured any disease. Neither
do lawsuits.
Maybe we need to cure ourselves of
listening to rhetoric and ignoring realities.