May 29, 2008

Law Says To Science, "You're Kidding Me, Right? "


The $253M Vioxx verdict against Merck is overturned.

(It was actually only a reduced $26M verdict, but since the media didn't highlight that fact when Merck lost, I'm following in kind.)

Meanwhile, A New Jersey court removed a $9M punitive damages award in another case, and upheld another Merck verdict in another case.

The court found no evidence that Vioxx caused a fatal cardiac embolus, because-- surprise-- there isn't any evidence.  At best we have an association, not causation, and it may be that the Vioxx itself has nothing at all to do with death.  (Though I realize that the law accepts association as evidence.)

The score is now Merck 11, plaintiff's attorneys 3.

Question: well, what are they supposed to do when there's some evidence that a drug poses a health risk?  Ignore it?

Answer:  who is they?  There isn't supposed to be a they at all.  (There it is again, the steady creep of social democracy, sister of narcissism.)  There's a chemical, it exists, doctors are supposed to know when to use it appropriately.  Not to mention it may later be discovered to have additional value (aspirin, thorazine, thalidomide, etc.) 

When you create a body to decide for doctors whether a drug is worth the risk, then you are saying you do not trust doctors to make this assessment.  Therefore, you do not need doctors at all, you need flowcharts.

Unfortunately, I'll admit, they might be right.







Comments

Who is "doctors?" Are doct... (Below threshold)

May 29, 2008 2:37 PM | Posted by Rose: | Reply

Who is "doctors?" Are doctors not individual human beings? Do you have a group mind? Do all doctors agree about the uses and dangers of Vioxx (or Zyprexa)?

Do doctors individually and collectively never make mistakes and always ground their decisions in careful and exact science?

Seriously. Have you read your blog?

Vote up Vote down Report this comment Score: 0 (0 votes cast)
No, nobody is saying you do... (Below threshold)

May 29, 2008 3:10 PM | Posted by Nathaniel: | Reply

No, nobody is saying you don't need doctors, they're saying that doctors can't each personally conduct decades-long double-blind medical studies across large, diverse populations.

You seem to be saying that medical care should be completely libertarian free-for-all, yet accept both that doctors should have some standard of training or qualification before being allowed to practice, and presumably think they should be held responsible (even if only contractually) if they lie to a patient about what they're doing.

Vote up Vote down Report this comment Score: 0 (0 votes cast)
You are a very insightful g... (Below threshold)

May 29, 2008 3:29 PM | Posted by asphaltjesus: | Reply

You are a very insightful guy, there's no doubt about it. Your writing style is thought provoking.

It is pitiful that the only stance you take is "what's wrong..." or "the irony of..." It's time for you to use some discipline and start sketching some "what's right" and "how do the wrongs change into rights?"

What you are doing now doesn't _do_ anything. It reminds me of the 80's nihilistic punk. You are just name calling with nothing to show for it. Take more chances. Throw some ideas out.

Vote up Vote down Report this comment Score: 1 (1 votes cast)
Oh, please, comparing Lasti... (Below threshold)

May 29, 2008 3:50 PM | Posted by PKS: | Reply

Oh, please, comparing Lastie to an 80s punk.

This seems like a strategy to defend the status quo - your position, when comparing lastie to an 80s punk boils down to saying "you shouldn't be criticizing or drawing attention to a problem UNLESS you already have a perfect, viable strategy to fix the problem."

Like how for an addict, the first step is admitting you have a problem, before a problem can be fixed, it has to be _identified_ as a problem.

And, wonder of wonders, it often turns out that finding a solution to a problem is orders of magnitude more difficult than simply identifying the problem.

And, btw - the correct usage is "80s", not "80's". The apostrophe is used for contractions, or to indicate possession. So are we talking about something that belongs to 80, or are you using a short form of '80 is'?

Vote up Vote down Report this comment Score: 0 (0 votes cast)
PKS,You are possib... (Below threshold)

May 29, 2008 4:32 PM | Posted by asphaltjesus: | Reply

PKS,

You are possibly:

A: misunderstanding my comments
B: blinded by fanboyism

Leaping to "perfect..." only serves to hijack the intended meaning of my post. Which a savvy reader should see as poor public discourse. Great advice on the grammar. You cleverly use the aside to launch another personal attack. Sadly, both attacks reflect poorly on your ability to reason and communicate like an adult.

My point still stands, this guy is smart enough to contribute more than just the same old "What's wrong with Topic XYZ" pablum.

Vote up Vote down Report this comment Score: 1 (1 votes cast)
Hi,docYes flow cha... (Below threshold)

May 30, 2008 12:45 AM | Posted by Diane Abus: | Reply

Hi,doc

Yes flow charts may do a better job . An informed to be user of drug, would look at the info, hopefully would assess more healthy remedies,meditaion,prayer,pain bio-feedback etc and if lazy ignorant or desperate may decide in favor of swallowing!

Vote up Vote down Report this comment Score: 0 (0 votes cast)
Flowcharts? You mean like T... (Below threshold)

May 30, 2008 10:06 PM | Posted by acute_mania: | Reply

Flowcharts? You mean like TIMA? Who's to say the academics behind the flowcharts are less incompetent than the clinicians?

Vote up Vote down Report this comment Score: 0 (0 votes cast)
Flowcharts? You mean like T... (Below threshold)

May 30, 2008 10:07 PM | Posted by acute_mania: | Reply

Flowcharts? You mean like TIMA? Who's to say the academics behind the flowcharts are less incompetent than the clinicians?

Vote up Vote down Report this comment Score: 0 (0 votes cast)
Oh, I am tired of all of th... (Below threshold)

May 31, 2008 9:48 PM | Posted by Dymphna: | Reply

Oh, I am tired of all of this.

Not everyone should be *allowed* to have the cool new bike with banana seat, sissy bar, and streamers. Why? Because some people belong on tricycles. And some people don't even have enough coordination for THAT - they should be walking instead.

Cox-2 inhibitors were never designed to take the place of every other NSAID on the market; they were designed to fill a void for the *tiny* percentage of people who had failed ALL of the existing NSAIDS. For those individuals, the risk/benefit ratio was acceptable.

Did this happen? Of course not. Vioxx and Bextra became the Neurontin of NSAIDS. Any little thing, and the "new, miracle, *better for your digestive tract* Cox-2 inhibitor" was just the ticket... any perky drug rep would have told you so.

The saddest part? Vioxx and Bextra really, really WORKED. (Celebrex sucks @ss). As directed, to whom they should have been given to in the first place, those drugs were a god-send. And when they were taken off the market? There was nothing left for many, many people. There are people out here who stay functional/walking/etc. by staying just behind the latest drug releases. In the NSAID department, another one didn't occur after the Vioxx/Bextra debacle.

Is it sad that people lost their lives? Certainly. Did all of them absolutely, positively NEED to be on a Cox-2 inhibitor? I seriously doubt it.

Vote up Vote down Report this comment Score: 0 (0 votes cast)