In the midst of all the alarms being sounded about the health risks from taking Vioxx and Celebrex, there is a story about National Football League players using less padding than in the past. What is the connection?
The NFL players know that padding gives some protection against injuries — but at a price. Carrying the extra weight of padding around slows players down, making them less effective on the football field and perhaps less able to quickly get out of the way of tackles and collisions. In short, they understand that safety is not a free lunch but something you have to pay for, in one way or another.
Most players wear some padding, just not as much as they are allowed to, or as much as their teams make available to them. In short, NFL players recognize a trade-off, as most other people do in most other aspects of life.
Where do people not recognize trade-offs? Where they are making decisions for other people. That’s where they make unrealistic demands, including demands for “safety.”
Maybe Vioxx or Celebrex is too dangerous, all things considered. Maybe not. The problem is that all things are not considered.
Too many people seem to think that if the risk of stroke or heart attack is doubled when you take some medication, that is the end of the story. But they would never apply such reasoning to practical decisions in their own lives.
Suppose you learned that the risk of being killed in an automobile accident doubled if you drove to work on the highway instead of driving through the city streets. What if the odds that you would be killed driving to work every day on the highway were one in a million, while the risk of being killed driving to work on the streets were one in two million?
And what if it took you 15 minutes to get to work on the highway and an hour driving through city traffic?
Some cautious people might prefer driving to work on the streets while other people would take the highway. Regardless of which group was larger, the point is that each individual could make the trade-offs when the facts were known. But that is not the way decisions are made, or even advocated, when there are “safety” issues, including issues about drugs like Vioxx and Celebrex.
Studies indicate that the great majority of people taking even heavy doses of these drugs over an extended period of time did not have either a stroke or a heart attack. However, the small number of people who did was greater than among those who did not take these drugs.
Obviously people would not be taking these or other medications unless they had a problem that these drugs were intended to help. The question then is whether the benefits exceed the costs or vice-versa.
This is a medical decision which can vary from patient to patient. Doctors are there to advise about these things, since these are prescription drugs — not something that a layman can pick up off a counter at the local drugstore.
But that is not good enough for “safety” advocates, many of whom have no medical training. If a drug is not “safe,” they say it should not be allowed on the market. But nothing is categorically safe.
Some people can die from eating ordinary wholesome foods like salmon or peanut butter. If the government banned every food that was fatal to someone, we might all die of malnutrition.
If a drug is not safe, neither is the illness for which the drug is prescribed. Nor are alternative drugs likely to be perfectly safe, since nothing else is. Life involves weighing alternative risks, whether in football, pharmaceutical drugs, or a thousand other things.
Politically, it is always easy to be on the side of the angels with ringing pronouncements about making sure our medicines are safe. Ideologues are in their glory denouncing “corporate greed” among drug companies. But ideology never cured any disease. Neither do lawsuits.
Maybe we need to cure ourselves of listening to rhetoric and ignoring realities.