The New York Times in its March 4th editorial, "Experts and the Drug Industry," has it wrong. Recently, the FDA decided to allow the drugs Celebrex, Bextra, and Vioxx to be marketed despite research showing they seem to increase the risk of heart problems. The Times complains that this FDA decision is suspect because a "vast majority" of the scientists on the panel had financial ties to the pharmaceutical industry and ten of the thirty-two panel members had consulted or received research support from the three drug companies involved in this judgment.
As the editorial did note, the argument has been made that the FDA would be hard put to find real experts in the field who have not had ties to the industry. After all, that is what these pharmaceutical scientists do: they conduct research, they devise test protocols, they perform experiments. They don't work in doctor's offices; they don't work for health food stores. They work for drug companies; that's how they make their living.
I doubt that, in the history of the FDA, any of their panelists have deliberately falsified information at the behest of their drug company benefactors. The panelists have insisted that their votes are not influenced by these ties, but the Times evidently feels that their avowals are overshadowed by guilt by association. I suggest that the Times check out this notion and, in fairness, print the results in another editorial.
While it's true that recent research indicates that these drugs may increase patient risk of heart and vascular events, it's also true that for many sufferers of chronic pain they dramatically increase the quality of life. Patients have been quoted as saying they want to continue using these drugs, that they will readily assume risk in order to live without pain. Anyone who has endured chronic pain, who has been unable to move freely, may feel the same way -- may rather live without the pain even if it means some possibility of a shorter life. I would agree: a pain-free life, even if shorter, easily beats an extended existence in agony.
This notion runs counter to what is called "the precautionary principle": a drug must not be marketed if it carries the slightest health risk, even if the risk increase is only evident when the drug is used on animals in huge doses. The precautionary principle, in its extreme interpretation, is "zero tolerance" for risk.
But a more intelligent and useful principle exists: the greater good for the greater number. It makes no sense to deprive the general population of life-saving or pain-relieving medicine because massive doses caused some mice to be discomfited. It is curious that so many who espouse zero risk are also the proponents of importing pharmaceuticals and taking unproven herbal remedies.
Dr. Marvin J. Schissel is a dentist and an advisor to the American Council on Science and Health, the National Council Against Health Fraud, and the Committee for Scientific Investigation of Claims of the Paranormal.
