Dean's World

Defending the liberal tradition in history, science, and philosophy.

Irrational Views of Drugs

Almost all pharmaceuticals--I know of only one exception, and it's not even legal--have a documented mortality rate. Almost any drug you put in your body has the potential to kill you, and the odds of it can be calculated pretty easily. Aspirin kills a few hundred people in the United States annually. Acetaminophen (Tylenol and similar drugs) can cause fatal liver toxicity, especially when mixed with alcohol. There is, literally, no pharmaceutical which does not have the potential to kill someone, although most of them have odds of killing that are calculated in tiny fractions of 1%.

I often think that people who are incapable of understanding this type of simple math should just admit that they aren't very bright and recuse themselves from discussions of subjects such as medicine, military matters, environmental matters, or just about anything else where any such simple math is involved. If you don't understand what a risk analysis looks like, you really shouldn't be opining on things like this.

Bill Ardolino notes a good case in point.

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Ted Armstrong (mail) (www):
With drugs there are two risks. One is the risk the drug will do damage. The other is the risk of those that DON'T take the drug will be worse off that before.

It seems that many people only look at how much damage a drug can do. But they forget about the people the drug would help, but may die because it is unavailable. One needs to make a reasonable choice between the two risks.

An air bag in your car may do you damage, but it could also save your life. You pays your money and rolls the dice.
8.16.2005 5:15pm
kbiel (mail):
There is one point that INDeCent Bill ignores; it is the manner in which the deaths attributed to RU-486 occurred. If you have an adverse reaction to penicillin or Tylenol, you are very likely going to know it and respond accordingly (if you are able). On the other hand, the symptoms of toxemia are exactly the same as the side effects of RU-486, so women are told to ignore the symptoms. Regardless of whether it is 4 or 40,000 women who died from this drug, that is a serious problem. The FDA is doing the correct thing in performing more research. Perhaps they will come up with a better recommendation, such as closer doctor supervision or white blood cell counts within a few days of taking the drug.
8.16.2005 6:36pm
Tom Hawkson:
I once complained to a doctor friend of mine that maybe doctors should have to take some of the drugs they prescribed, so they would know what the side effects were like before describing them as minor. He said that he could not support the indescriminate ingestion of toxins.

This single sentence description of what drugs really are so crystalized my thinking on the subject that I am no longer unhappy about such risks.

My friend is known, among his friends, for making such short and memorable statements that totally change the way people think.

What a gift.

Yours,
WInce
8.16.2005 7:22pm
Jeff Licquia (mail) (www):
I agree with you, kbiel, that we should figure out whether we can prevent more of the RU-486 deaths. And I do think Bill was being a little shrill in that post.

But if you're advocating pulling the drug, it doesn't appear the science is there. The alternatives likely have higher mortality rates; childbirth is cited as being 25 times more deadly to the mother, for example. You can only justify pulling the drug if you can prove that doing so would reduce mortality.

I am conflicted about the morality of RU-486. But I don't fear arguing that point on a moral level, nor do I feel the need to palm a science card to get a winning hand.
8.16.2005 7:41pm
TallDave (mail) (www):
Hehe, I know what exception you're thinkig of ;)
8.16.2005 8:27pm
Bill from INDC Journal (mail):
And I do think Bill was being a little shrill in that post

I have to wonder what type of post constitutes not being shrill. Malkin's post essentially declared RU-486 a murderous drug, I deliver statistics, yet I'm "shrill." I honestly scratch my head at that. The only shrillness I can think of was my parroting of mirror-image quotes to the ones Malkin used or cited - which was done to point out that shrillness is bad.

As for the manner in which the deaths occurred, kbiel raises a good point. But that does not change the analysis to "Regardless of whether it is 4 or 40,000 women who died from this drug," as that's just silly. My point was that the incidence of death is remarkably low, and it is.

Though Anaphylactic Shock can kill one right quicker than an infection, btw.
8.16.2005 8:36pm
McKiernan:
I didn’t find Michelle to be hyperbolic in condemning “approved medical protocols” although your choice of words regarding a handful of undesirable adverse reactions would seemingly give credence to that effect. I suspect she is being much more direct to the issue of human life.

Mind you now that life in all instances has a mortality rate of one hundred percent. The issue here seems to be who gets to live with the dangers involved,and when such death occurs.

One’s analysis of Michelle statements as “embarrassingly naive or intentional demagoguery” are highly problematic. Meanwhile, the incidence of death to the unborn is 100% since Mifeprex is a drug invented to kill the unborn, while misoprostol is intended to contact the uterus to expel the recently deceased.

Occasionally the human female body reacts negatively to innate decaying human tissues thus upsetting the pharmaceutical protocols one wishes so dearly be followed and rather the infectious process follows its normative course to the detriment of the person desiring to continue their post-pharmaceutical life span.
8.16.2005 9:15pm
Dean Esmay:
If it's deaths we're talking about, then let's look at deaths by childbirth, death by D&C and other abortion methods, and death by RU-486, and see what the comparison rate actually is.

And, of course, fully inform the patients of the risks in all cases.

I note another comparison however: all women who use tampons, of any variety, run a risk of developing Toxic Shock Syndrome. From what I understand, several women a year still die from this. You'll find the warning notes in every box.
8.16.2005 10:34pm
cardeblu (mail):
I always thought "RU-486" was an interesting question...

Kinda/sorta on topic: It is now official in the state of Oregon. You have to get a prescription from your doctor to buy Sudafed or NyQuil (any pseudoephedrine-containing cold or allergy product). Who's next?
8.16.2005 10:45pm
maggie may - labrat:
Acetaminophen (Tylenol and similar drugs) can cause fatal liver toxicity,

Having known three victims of this particular phenomena, I can tell you that "doing the math" doesn't make me feel all that "warm and fuzzy" and that stuff won't be found in my medicine cabinet. You may have been aware of it, but they didn't have a clue that taking a tylenol for a headache could leave them dead in a matter of days. Therapeutic doses all three. All previously taken with no adverse affect. I don't care how many millions safely take it every year. If I want to take RU-486 to abort my child, I want to be told that a rare clostridium infection is a possibility, what to look for and how to avert it. I don't want to be told that thousands take the drug safely and there are a few "rare" side effects. Death is a pretty damned serious side effect, no matter how remote the possibility. Let me do my own well informed risk/benefit analysis for me, not a cohort.

Note the "rosy" picture painted at this site.
http://www.abortbypill.com/
8.17.2005 12:25am
willem:
If it didn't have a side effect it wouldn't be a drug.

What makes something a poison? The dose. In a weird, unexpected way, inorganic nanoparticulates may prove to be the first exception to that rule which has held for centuries. Particles smaller than the interstices between cells can wreck biological function mechanically at the cellular level. The scope and implications of our increasing knowledge in human toxicology portend a future of profound social and legal upheaval. The politics and hyperbole surrounding RU-486 is child's play compared to what is coming.
8.17.2005 1:07am
Bill from INDC Journal (mail):
Let me do my own well informed risk/benefit analysis for me, not a cohort.

Exactly. That being said, side effects do happen.

As for McKiernan's:

One’s analysis of Michelle statements as “embarrassingly naive or intentional demagoguery” are highly problematic.

#1 - That line did not specifically refer to Malkin.

#2 - Malkin's portrayal of RU-486 as an exceptional health risk "victims of choice" was demagoguery of the issue

It seems rather silly to argue that point, after merely reading the post's title.
8.17.2005 1:56pm
zach.:
McKiernan,

i think you're missing the point that bill is making here. a moral argument may be made against RU-486, if that's where your morals lie, but the michelle malkin was not making that argument. she was attempting to argue against RU-486 using numbers quoted in a misleading fashion, along with sympathy-garnering sob-stories. and i also think you probably didn't read the part of bill's post that dealt with probable causes of the infections that led to death. it wasn't from some decaying fetus in the uterus (as your comment implies), but rather likely from the method in which the drug was administered, or a contaminated batch of drugs. both of which could be corrected in the future.

the argument here is not that RU-486's intended use is good or bad, the argument is that on its merits its side effects (even serious ones) are not out of line with other commonly accepted over the counter drugs. indeed, pro-life advocates should be praising bill's post. the more conservative pundits rail against RU-486 using faulty statistics and willful ignorance, the weaker their arguments become. and i'd rather my mistakes be pointed out by a friend than an enemy.
8.17.2005 2:49pm
McKiernan:
Zach,

It was reported that Holly Patterson, "...died from septic shock and infection resulting from incomplete expulsion of the fetus." This was one week after taking the pills. Holly's family in turn filed a lawsuit in December 2004 against the manfacturer of the pill.

Michelle's article IMO seems a lot more benign in its presentation than Bill's counter would seem to indicate.
8.17.2005 3:59pm
Jeff Licquia (mail) (www):
Bill:

I have to wonder what type of post constitutes not being shrill.

Well, I did say a little shrill. Also note that I was defending your main point, and said nothing about Malkin (who, I agree, was also being shrill).

But statistics alone do not an even temper make.
8.17.2005 4:02pm
zach.:
McKiernan,

clearly i didn't know as much as i thought i did, and concede your point about holly patterson. however i still feel that the danger in her case probably didn't result from RU-486, but rather from the poor instruction and care she received from Planned Parenthood. I still maintain that Malkin's article is positing an unfair standard for a drug to meet simply because it happens to deal with abortion. Would Malkin or anyone else waste their time, blog space, and energy on this topic if the deaths were due to a drug for, say, bronchitus? and i think anytime anyone uses numbers in an unfair manner it's not very innocuous. people are too ready to believe what they read, especially if it has a number in it (and i'm just as guilty on this as anyone else). therefore journalists and blog authors have an increased duty to try their best to prevent facts in the correct manner, making their case as honestly as they can. and it's my opinion that malkin was engaging in at the very least an intentional and willful ignorance here.
8.17.2005 10:13pm