Asymmetrical Information

I'm no supporter of Ralph Nader, but I also would caution against jumping to conclusions in the Cylert matter. It's rather hard to imagine that the FDA would yank a drug off the marketplace solely due to pressure from an advocacy organization. Most likely the pressure just reinforced a decision that the FDA already was going to make.

I ahve to disagree with you. The main goal of FDA employees is not to ensure that the American public gets exactly what it needs; it is to ensure that the American public gets what will not get the FDA in trouble. The FDA is hugely biased towards preventing negative outcomes, even when the patient is fully informed of the risks; "FDA allowed drug that killed my daughter" is a much worse headline for them than "FDA too cautious about potentially dangerous drugs".

This is simply delicious. The vast majority of Making Light readers (and all of the contributors) are raging liberals who bow down before the regulatory gods as a matter of course. Will this supposed terrible error of judgment make any of them rethink the whole enterprise and imagine for a moment that this might be how quite a lot of decisions are made, and that many of them are bad?

Not likely.

Dylan - agreed. I've never seen a better example of BDS than a comment by 'Xofer' that implies the FDA response to Public Citizen is the fault of the Bush admin.

Also note that until just about his last comment, the only non-liberal commenter is regularly 'disem-voweled' to render his posts unreadable.

An addition....

My observation about the post and comments on Making Light are made without glee and only a little schadenfruend.

When your worldview collides with what someone else might believe is in your best interest, worldview is gonna win everytime.

The role of the FDA should simply be to ensure that testing is done to reveal risks, and that the results of those tests have been entirely disseminated to those seeking to use the drug. Drugs should be allowed to be sold while testing is underway, as long as it is made known to the customer that efficacy has not been established, nor have potential side-effects been identified. Torts should be restricted to those instances which a drug company falsified or failed to reveal test results. Citizens should be treated as citizens, not as wards of the state.

Authoritarians like those make up groups like Public Citizen are engaged in very, very, bad, if not outright evil, behavior.

I'm discouraged by the apparent need of some of the Making Light folks -- not all, but some -- to make this into a partisan fight. This isn't about Bush and it's not about Republicans versus Democrats; it's about the real consequences the FDA's decision is going to have for people who rely on that drug. You can oppose Bush and support the FDA's decision; you can support Bush and oppose the FDA's decision.

But anyone who opposes that decision is on the "right side" of this issue, and splitting that group of supporters up further verges on insanity. If I were challenging an entrenched lobbying group and an even more entrenched federal bureaucracy, I'd want all the help I could scrape together.

Funny, I was mostly under the impression that the Making Light commenters (not to mention the Haydens themselves) are (if of any obvious political bent, which in many cases is not apparent in that thread) more crazy-ass Libertarian-with-a-capital-L than crazy-ass Liberals.

Makes me glad to be an old Whig ala Hayek.

The Nielsen Haydens are unorthodox New York liberals. That is, they are hard-core Democrats, which is the "New York liberal" part, but they have a thorough and comprehensive understanding of and respect for basic human cussedness, which is what makes them "unorthodox". (I should add that this latter trait makes anyone unorthodox, regardless of formal political commitment.)

The comment by one James MacDonald to the effect that personal responsibility was surely a liberal value made me smile. It reminded me of a conversation I had some 20+ years ago with an earnest liberal who assured me that no one was really in favor of equality of result, nope. Given that we'd both heard the same commentary on NPR less than 48 hours earlier calling for equality of result in a multitude of ways ("Comparable worth" was only one) I had to marvel at his abilities in self-deception.

None of us like to revisit fundamental premises. It is uncomfortable, because some of our self-image is bound up in those positions. It was a bit sad, but predictable, to see the narcoleptic woman insisting that there's nothing wrong with the ideas of government regulation & "public interest" organizations, they just messed up this time. I am reminded of the Russian peasants of the 19th and early 20th century who lived in the certainty that Little Father Tzar loved them, and the only reason bad things happened was all those wicked nobles who kept the truth from him.

It would be hard to give up a diety, especially in dire straits such as Theresa finds herself in. But why do so many people choose to make a clearly flawed human insitution like government their "god"? I've never understood that...but I'm not from New York, and I've never been much of a liberal, even in my college undergraduate days. So there's a whole lot of premises that the Haydens and I do not, and never will, share.

I feel very sorry for this woman. I wonder if she, or any of her friends, looked at the smoldering ashes of Mt. Carmel nearly 13 years ago and "questioned authority" or thought "Gee, government guys could do that to me, too!" at all? Did they ever feel sorry for other victims of government? I do feel very sorry for this woman, as I feel for many, many, many other people, some of them with no known name...

Brian wrote:

This is simply delicious. The vast majority of Making Light readers (and all of the contributors) are raging liberals who bow down before the regulatory gods as a matter of course.

100% agreed.

I blogged on this earlier:

http://tjic.com/blog/2006/01/04/from-the-all-in-favor-of-the-nanny-state-until-it-infringes-their-freedoms-file/

from the "all in favor of the nanny state, until it infringes *their* freedoms" file:

PATRICIA NIELSEN HAYDEN writes ...

Collective decision making is *always* better than individual freedom, it seems, until such time as the collective disagrees with you. Then it sucks.

Gee, wish I'd thought of that.

Neel Krishnaswami wrote:
The Nielsen Haydens are unorthodox New York liberals. That is, they are hard-core Democrats, which is the "New York liberal" part, but they have a thorough and comprehensive understanding of and respect for basic human cussedness, which is what makes them "unorthodox". (I should add that this latter trait makes anyone unorthodox, regardless of formal political commitment.)

It's been a very long time since I met anyone who was a genuine, hard core Democrat liberal that actually had any comprehension of basic human cussedness. I've met more than a few that claimed such, but they couldn't really demonstrate it. Like the libertarians who talk a good line of "resist!", but who, though able bodied, are unable to fight in any meaningful way, liberals like to pose as lovers-of-mavericks, even as they do their little part to make the world ever safer from genuine curmudgeons, whether by voting for Nader right up until they curse him, aiding the "wildlands" groups in depopulating the countryside (especially of cantankerous coots), promoting an ever-widening web of "safety" regs that don't make anyone actually safer, or any of a number of other kind, gentle, suffocating ways...

promoting an ever-widening web of "safety" regs that don't make anyone actually safer,

There was a wonderful example of this a few years ago. Remember the push to have infants in commercial aircraft in safety seats? It was pointed out that (1) this would likely increase the number of infant deaths, since more families would drive instead of fly if they had to buy their infants their own seats, and (2) even if the risk of driving were ignored, the cost per life saved would exceed $1 B!

The NTSB and some congressmen resisted this rational analysis. Ralph Nader himself said something to the effect that actual children killed in air crashes counted while statistical children killed in extra car crashes did not. I wonder if ol' Ralph also disbelieves in those statistical (and epidemiologically unfindable) extra people killed by cancer from low level radiation?

Oh: the FAA finally canned the proposed child seat regulations last year, after the raving irrationalists had moved on to something else. It helped that some families who were (on their own) buying seats for their infants were being kept off planes because the infants' names were coming up on the terrorism 'No Fly' list!

One of the reasons they're "unorthodox" is that they're both big-time SF fans. (They're SMOFs, in fact.) I'm pretty sure they both work in the industry, too. I have a vague memory that they work at Del Rey books as editors, but that's probably not correct.

I knew of them because of fandom long before I knew of them because of their political positions (after all of us started blogging about the war).

Steven Den Beste wrote:
One of the reasons they're "unorthodox" is that they're both big-time SF fans. (They're SMOFs, in fact.) I'm pretty sure they both work in the industry, too. I have a vague memory that they work at Del Rey books as editors, but that's probably not correct.

Ok. I've never met them, and likely never will. Maybe they are the exception to my own experience. More than once I've met liberals who prided themselves on their tolerance for cussedness, who regarded anyone in the NRA as a neo-Nazi (to pick one example, from many) and anyone who owned a gun as insane, anyone who hunted as a murderer, etc. and so forth. Based solely on their responses so far to this bad situation, they look just like any number of people I've known across the US. But I'll be the first to admit that viewing someone's writing under such an unpleasant and stressful situation is a skewed sample.

I knew of them because of fandom long before I knew of them because of their political positions (after all of us started blogging about the war).

Ok. I've never been interested in fandom, and thus there's a whole lot of people I don't know about. Hope your health is doing ok. Take care.

Weirdly enough, they've identified the guy from AEI they're slagging there as an astroturfing Right Wing Death Beast as Ted Frank, the Kibologist. It's rather strange watching old names from USENET enter the blogosphere.

Dylan and Chris B. Listen to yourselves.
Delighting in the misfortunes of individuals as representatives of a group you dislike. Will you call them Kulaks next?

I don't care how this got started. Cylert is a good place to start the discussion of how to deal with orphan drugs in general and how to rank drugs by usefulness / hazard. The bureaucrats and doctors-who-never-practice at the FDA need some correction and alignment with human values.

Not sure whether a site admin will read this, but YOUR FRONT PAGE IS KNACKERED.

Jame Galt got it right. Don't read any more into this than bureacratic fear of damaging headlines and activist need to gin up contributions.

"But if they weren't pushing to get anything banned at all, people would say, 'Why are you guys still in business? Why are you still asking for donations?'"

This is extraordinary logic. I mean, since my dentist has no financial interest to remind me to brush and floss (and show me how to do them correctly), and, in fact, as great financial interest for me to have awful teeth, I should believe that she's being disingenuous whenever she tells me to take care of my teeth? (My dentist does have personal and professional integrity, as do those who work for Public Citizen, but, reading the post & comments, that's easily dismissed.)

Sammler is correct, YOUR FRONT PAGE IS KNACKERED. At least on Firefox.

It's also knackered in Internet Explorer v 6.0. The "Search" part of the right sidebar has expanded to 80% of the width of the page. Jane's post is crammed into a little box on the left, that cuts off before the end of the post. I could only get to comments, not to mention other posts, by scrolling down to find the archives.

Jane's quite right here.
The FDA has managed to pick the safest possible position for itself. Patient needs are not paramount here.

The whole matter comes down to how one feels about choice. In general, capitalists prefer to allow people to assess the risks and benefits, make their own choices, and accept the consequences.

Socialists prefer to have a central authority make choices for others. The governing elite know what's best for you, and decides accordingly.

If you prefer autonomy, you will retain choice in the matter of health care (e.g. certain doctors, medicines like Vioxx, procedures like plastic surgery). If you prefer solidarity through egalitarianism, the government will come down on the side of safety (although the safety will be for them, not you), and choices will be made for you.

There is no third way offering choice without risk.

Partha: I'll believe your dentist has personal integrity, but in any case, there are enough people that don't take care of their teeth to ensure dentists have work. Also, she might actually be making more money if you take care of your teeth, including those regular visits. My dentist has made far more from my preventive care (cleaning/checkout/indoctrination session for $70 every 6 months for ten years) than from my cavities, and she referred me to someone else for the most expensive job (wisdom teeth extraction).

What I know of Nader's record does not lead me to believe in his personal integrity. At best, he loses perspective once he gets into a case, which just makes him a good lawyer...

Ellipsis wrote "

I wonder if she, or any of her friends, looked at the smoldering ashes of Mt. Carmel nearly 13 years ago and "questioned authority" or thought "Gee, government guys could do that to me, too!" at all? Did they ever feel sorry for other victims of government?"

One reason I don't ask this question of myself is that I don't go around raping children, murdering ATF agents, locking myself in a stronghold, engaging in armed confrontation with our goverment, which had the legal right to search my premsise and then spread kerosene all over the place and speak about the coming end of the world as if Revelation were do to happen immediately.

Integrity vs. Self Interest is not always all-or-nothing. Although there may be aspects of Public Citizen that have integrity or they may pursue some worthy causes, that alone does not guarantee institutional integrity. In fact, whatever percent of their activities that might be deemed worthy (let's say by a large majority of people) can easily be used as a giant rationalization to justify activities such as trying to ban Cylert. In many respects part of the problem is the creation of such an organization and institution in the first place. Bureaucracies are often very effective at accomplishing certain tasks (such as mobilizing to get Cylert banned). There are some issues for which such mobilization can be justified. Yet, these are probably best understood as ad hoc issues. An institution like Public Citizen would say that it's looking out for the "little guy" who cannot mobilize so readily and who could not bring issues to the attention of the majority. Yet, Public Citizen is advocating a position that hurts the very people it is presuming to protect. Public Citizen is not claiming to protect people who don't take Cylert but those that do. However, it's those that do who are saying, "let me decide the risks". This is nannyism run amok.

Dentists who tell their patients to brush and floss have integrity, but if people brush and floss, dentists will not go out of business. In fact, if a particular dentist is successful at reducing cavities, etc., he/she will likely get more business as a result and/or offer even more lucrative services such as teeth whitening. Having integrity is not axiomatically incompatible with financial or other success, although it can be sometimes.

Considering the topic, think about Ralph Nader for a moment. This is a guy who looks like he never sleeps. Maybe if he were taking Cylert for narcolepsy, he'd be giving a second thought to banning it. If he thought taking Cylert to manage narcolepsy or ADHD helped him hunt down "evil" corporate interests, he'd probably be demanding that the government give it away free of charge and give him a liver transplant to boot.

Public Citizen justifies itself to donors by ticking off a list of laws/regulations created and changed. Suppose leaving things as is might often be the best policy. It would shorten the list considerably. Watchdog agencies require watchdogs. Perhaps the blogosphere will help shed more light on this issue, so that it can be dealt with in a less ham-handed way. It won't change the modus operandi of Public Citizen, but issues such as these can enable people to talk about risk vs. benefit and who should make the choice.

Kevin Marks ... read my 2nd comment.

I do hope things work out for the best for them but it's really hard to read some of the comments without shaking your head over how this is an example of people will twist logic and facts in to preztels to avoid questioning their assumptions about how government functions. It's an object lesson in what's wrong with attitudes like those found in What's the matter with Kansas.

Your reference to Kulaks is puzzling. If somebody made me king, then Public Citizen would definitely *not* have been able to get the FDA to ban this or any other useful drug.

"Public Citizen justifies itself to donors by ticking off a list of laws/regulations created and changed. Suppose leaving things as is might often be the best policy. It would shorten the list considerably."

This is, of course, exactly the same way as elected officials justify their tenures and run for reelection, and is a key reason that we're on the non-stop train to nanny-state Nirvana.
:-(

I forget the exact quote, but I heard the late Sen. Patrick Moynihan on CSPAN. I believe it was a press conference in spring 2001 if I remember. Congress had enacted a bunch of legislation (the first Bush tax cut and Education bill, etc.). He said that since they had passed such major legislation, he thought Congress should give it time to see what happens and therefore there was probably no need for Congress to meet for the rest of the year. They could reconvene later and see what's up. Now that was Senatorial.

My bad on the Moynihan timeline (probably wishful thinking). Gonna have to go back to 1998, but the gist of what he said remains the same, i.e., have Congress go home and come back later.

Federal bureaucracies don't seem to have many friends among this blog's readership.

I asked my psychiatrist about Cylert today (I take two different meds for ADD), and she said:

1. It's been found to cause liver damage in some people.
2. Its recall wasn't unexpected.
3. She hasn't prescribed it since the 1980s.

I make no claims that she's got the definitive opinion, but the FDA might just be right.

John, if you'd read the article Jane linked to, you'd know that the alternatives to Cylert don't work for everyone, and that for some people it's the only thing that allows them to have anything like a life. I was ADD and I can't imagine that being serious enough to risk liver damage - but for a narcoleptic like the one cited in the article, without a drug that controls the condition just leaving home is life-threatening, as are a good many activities that I routinely do at home.

I'm glad Public Citizen got the Cylerts banned, what with all the trouble they were causing for Commander Adama on Battlestar Galactica.

What? Oh.

Never mind.

Dylan, Chris B., TJIC - I'm a friend of the Nielsen Haydens. They've welcomed me into their home several times, and we've sat and talked and laughed for hours on end. Combined, they are more intelligent and better conversationalists than everybody west of the Mississippi.

She is one of the most intelligent people I've ever talked to--and I've talked to a few real geniuses.

And now you two think it's it's "delicious" that she should be sentenced to a life of mental disability because of her political beliefs?

Your statements are about the cruelest and most heartless things I've read recently.

ellipses - The comment by one James MacDonald to the effect that personal responsibility was surely a liberal value made me smile.

James Macdonald has raised four children, risked his life for his country in the U.S. Navy, and now works as an Emergency Medical Technician in New Hampshire winters. He has taken personal responsibility for his own life, and for the lives of others, every day of his life. How about you?

ellipses - The comment by one James MacDonald to the effect that personal responsibility was surely a liberal value made me smile.

James Macdonald has raised four children, risked his life for his country in the U.S. Navy, and now works as an Emergency Medical Technician in New Hampshire winters. He has taken personal responsibility for his own life, and for the lives of others, every day of his life. How about you?

I've taken responsibility for myself and others under my care ever since I first voted for Nixon, thanks for asking, and in all those years one of the few constants has been those people who demanded I pay for someone else's mistakes, no matter how many times they have made them. This was, and is, just one of the faces of "liberalism"; the socialization of personal responsibility such that no one is ever held accountable for their own actions.

The notion that personal responsibility is a liberal value has been risible to me for over 30 years, based upon things seen with my own eyes and heard with my own ears. But I'm sure you know more about my life tha I do, and can set me straight on what I really saw, heard, and believe, so do carry on...

One more observation is in order: Mitch Wagner has engaged in a classic logical fallacy. Whether James MacDonald's claim that personal responsibility is a liberal value is true or false is not affected by his personal life; the truth or falsity of a statement is independent of the person who says it, you see. Changing the subject from whether personal responsibility is a liberal value, to whether James MacDonald is a better person than I am, is a classic, classic example of liberal "debate"...

Thanks very much for reminding me what I have learned about liberals over the years, and especially during the Clinton administration...

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