Friday, November 18, 2005

complacency kills

I always stress this meme when explaining the unintended consequences of the even most benign-sounding legistlation. As Lisa Casanova said it some time ago on

The FDA should be totally shelved. No one should be in charge of keeping “marginally safe” drugs off the market, since there is really no such thing. There are no safe or unsafe drugs, only the tradeoff of risks and benefits that is unique to each individual making the choice to take the drug.

In a way, I think that abolishing the FDA might make big lawsuits less of a problem. Right now, people have this idea that drug safety is something they don’t need to concern themselves with, because someone else worries about it for them. They think someone is going to magically know alll the risks and benefits of a drug and tell them, “you can take this drug with zero worries. It’s nice and safe. Go ahead and pop that pill!”

Consumers of drugs get the idea that if the drug is on the market, that must be a sign that nothing bad can happen to them if they take it. If something bad does happen, someone must be to blame, since it was the job of somebody else to make sure the drug was safe, and nothing bad should happen to you if you take approved drugs, right?

Right now, people who take drugs that turn out to have serious risks have this attitude that someone let them down by not making sure that the drug they freely chose to take had no risks. Maybe people buying drugs on the market need to adopt more of a mindset of participants in a clinical trial, one of “I’m stepping into the unknown here. Is it worth it to me?”

If people knew that every time they take ANY drug, they are taking a risk (which is the way things really are), then maybe people would give lots more thought to drug safety than they do now, and outside of cases of companies committing fraud or hiding information about risks, it would be harder to blame someone else every time a drug turns out to have ill effects.
There was also an article in Wired magazine, back in December 2004 which promoted the similar concept of road anarchy, in which 'The approach is radically counterintuitive: Build roads that seem dangerous, and they'll be safer.'

The idea behind it was to remove all the safety devices that drivers have come to take for granted and have lulled them into complacency; road stripes, speed signs, demarcated curbs, traffic lights, etc. This reintroduces the drivers to the reality of what their vehicle is truly capable of if mishandled. Drivers tend to drive slower and keep mindful of pedestrians who are walking just a few feet away and whom no longer enjoy the illusion of safety of an elevated curb. The removal of the road stripes makes drivers drive closer to the side than center of the road, because road stripes subconsciously allow them to drive "in their lane" instead of driving safer and closer to the side. The same goes for speed signs -- take them away and the drivers will gauge the risk of high-speed driving, instead of relying on road signs to give them a roundabout figure of the safety margin.

It even seems to encourage greater road cooperation:

Monderman and I stand in silence by the side of the road a few minutes, watching the stream of motorists, cyclists, and pedestrians make their way through the circle, a giant concrete mixing bowl of transport. Somehow it all works. The drivers slow to gauge the intentions of crossing bicyclists and walkers. Negotiations over right-of-way are made through fleeting eye contact. Remarkably, traffic moves smoothly around the circle with hardly a brake screeching, horn honking, or obscene gesture. "I love it!" Monderman says at last. "Pedestrians and cyclists used to avoid this place, but now, as you see, the cars look out for the cyclists, the cyclists look out for the pedestrians, and everyone looks out for each other. You can't expect traffic signs and street markings to encourage that sort of behavior. You have to build it into the design of the road."

If there ever was a great argument for anarchy, this is it.


Vache Folle said...

I reckon that some private organizations would pick up the slack and provide testing and information like the Insurance Institute does with cars and UL does with appliances.

iceberg said...

There are a number differences between private agencies and those of the state which I'm sure I'm just preaching to the choir.

1. Efficacy- only private agencies have incentive to produce products of or rate the reliablilty, safety, and other qualities of products that consumers care about. While there is always the specter of corruption, multiple, competing private agencies are still better than having only one-point-of-failure, which could be a corrupt state agency. Furthermore, the mere existence of the state agencies could possibly crowd out private agencies from providing their own ratings for the particular need.

2. Unfortunately, the state and its agencies have the aura of being competent. This lax and unvigilant attitude on part of the consumers is based on the assumption that negative incentives (state punishments) will keep the parties involved honest about the risks. One example where I noticed complacency: There is a Jewish halachic requirement that says that even though cow milk is kosher, you can only drink it if it was milked in front of a Jew, for fear that an unsupervised non-jew might substitute pigs milk, or other unkosher milks into the cows milk. One famous rabbi made an exception and said that you can drink milk even without supervision in America since the FDA will punish a milk processor who combines unkosher milk with cows milk. This is exactly what I'm talking about.

Hence, I don't think private agencies would have the same issue of creating complacency, as there is no belief in the infallibility of private agencies.