Medical roundup

  • “No, Donating Your Leftover Tissue To Research Is Not Like Letting Someone Rifle Through Your Phone” [Michelle Meyer answers “Henrietta Lacks” author Rebecca Skloot; related, Richard Epstein/Hoover]
  • “Women Should Not Have to Visit a Doctor for Birth Control” [Jeffrey Singer, Time/Cato]
  • Lawyer ads can scare TV viewers into discontinuing medically indicated therapies. But is more regulation the right answer? [reform group Sick of Lawsuits]
  • Johnson & Johnson followed federal government’s own advice on labeling a drug, and got slammed by a jury in consequence [WSJ editorial]
  • U.S. opinion resistant to ratifying treaties that would create an international-law right to health care, so how about smuggling it in via congressional/executive agreement? [Nicholas Diamond, Harvard “Bill of Health”]
  • Denmark, like other Scandinavian countries and New Zealand, has replaced malpractice suits with iatrogenic injury compensation scheme [Pro Publica]
  • Has liberalized patient access to opioids been a net harm? Study suggests no [Tyler Cowen]

6 Comments

  • Re: J&J.

    There seems to be a temporal problem. The child got injured in 2003, but the FDA did not make a decision until 2005.

    That said. I really don’t think that a warning label would have helped. Come on. Do you think that a parent would have read it? No!. More likely, the parent would trust J&J not to put out a dangerous product.

    This is one of those cases where our tort system does not completely cover realities. Society should take care of these tragedies and not leave them to impoverish individual, unlucky families.

    • “This is one of those cases where our tort system does not completely cover realities. Society should take care of these tragedies and not leave them to impoverish individual, unlucky families.”

      Then society, not J&J should be the ones to compensate them.

  • Epidermal necrolysis is a rare idiotypic (occurs in individuals without any means of identifying who might be sensitive) response to many commonly used drugs. Incidence is in the range of 1 per million people exposed to these drugs, most commonly sulfa based antibiotics, but also drugs from many other classes.

    Idiotypic responses are a crap shoot. for the 999,999 out of a million people who do not react badly to ibuprofen, it is a wonder drug: cheap, reliable, effective, wide therapeutic margin, and gets the job done for fever relief, and pain relief. Many have a day of function restored due to non-steroidal analgesics, whether it is return to school for a kid with fever, eturn to work for a parent with a kid who is back in school, return to work for an adult with musculoskeletal pain or severe headache, or other regained productivity. I can be certain that I have several days per year restored to me that would otherwise have been ‘lost’ due to inability to adequately function.

    So is ibuprofen a good bet for the person who does not know if they are going to be the idiotypic responder (aka unlucky looser)?
    Drug taken by 1,000,000 people. Assume conservatively only 1,000,000 days of life gained through improved function, and 25,000 days of life lost (70 years for one person). That is the economist perspective on risk benefit analysis. Same sensible group that tells us to take our lottery ticket money and invest in real savings versus a pipe dream.

    So, ibuprofen, good value, except for the rare one person who has the horrendous outcome.
    But is $100,000,000 to one unlucky person, with none to the other unlucky folks a good distribution?

  • Re: Denmark and socialized no-fault malpractice.

    The American lawyer says it all:
    “Scott Eldredge, … said he is “completely opposed” to a compensation system like Denmark’s. Eldredge acknowledged that the U.S. malpractice system is “tilted in favor” of medical providers, and that most patients can’t get an attorney because their cases aren’t worth enough money. He said he turns down 98 out of 100 of cases he reviews.”

    So he personally tells 98% of folks they are shit out of luck in his world. And that somehow justice for the 2% is fair enough in his book.

    • “So he personally tells 98% of folks they are shit out of luck in his world.”

      Consider the possibility that a significant portion of that 98% are seeking compensation that they genuinely do not deserve.

    • I think its probably safer to say that the US malpractice system is “Tilted in favor” of the lawyers. Any benefit is gained by the healthcare providers, insurers or the patient is purely coincidental.