"Regulation
for Dummies: Is the FDA necessary?", by Todd Seavey. A
review of Protecting America's
Health: The FDA, Business, and One Hundred Years of Regulation,
by Philip J. Hilts. Review published in Reason, Vol. 35 No. 11 (Apr 2004),
pp. 51-55.
Criticized by Steven Blatt
"Should the law be fashioned for stupid people?" p. 51
"Think of the FDA, when it functions properly, not merely as a hobbling
bureaucracy but as anti-fraud law applied to food and medicine.
The question is how to tease out the FDA's useful functions--preventing
fraud and injury--while eliminating its more burdensome regulatory
functions." p. 54
"Where one comes down...will hinge in part on how savvy
one thinks the general public is, relative to scientific experts (such
as the ones who end up working for the FDA), about evaluating medical
claims. To anyone acquainted with the general public's track
record, the case for the bureaucracy looks surprisingly strong."
p. 54
My criticism is that Seavey doesn't consider a
particular alternative to FDA regulation: The FDA could offer the
same approval processes that it does now, but participation by
pharmaceutial companies would be voluntary. People would be
allowed to buy drugs which had not been submitted to the FDA for
approval; they would also be able to buy drugs which had been submitted
for approval before the approval process finished, or if approval had
been denied--but in any of these cases the purchasers would be required
to have one or more conversations with an FDA official who would try to
convince them not to use the product. Of course, people could use
drugs that had been
successfully approved by the FDA just as they do now, with no
"conversation" required. This proposal would greatly
decrease
the "inherently coercive nature" (p. 55) of the FDA. At the same
time it would preserve to a great extent the FDA's anti-fraud
role: Someone who decides to try a product after being fully
informed that it is ineffective or unsafe is not the victim of a
typical fraud.
There are objections to this
proposal. Also, if we decide the proposal is a winner we would
have to agree with Seavey that "there is no avoiding some sort of legal
constraint on food and drug sales" (p. 55). And Seavey's article
is intended as a book review, not a
comprehensive survey of the FDA issue. Nevertheless, I think the
mandatory
conversation approach is an important alternative to keep in mind when
discussing the FDA and that Seavey's article would be better if he had
considered it.
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