Libertarianism and drugs

Libertarianism is the political philosophy of middle school boys and arrested development. This is well-illustrated by the bleat that people should just “do your own research.”

Look, I made an entire career out of research and was well-compensated for my judgement. But I certainly wouldn’t trust my judgement on which drugs are safe and effective and which aren’t. Apart from my lack of expertise, there’s the issue of the data:

“Some of the detailed data the FDA receives from a drug's manufacturer is considered the company's private property and is kept secret, so any outside reviewer isn't playing with a full deck.

“Furthermore, evaluating the results of a clinical trial can be tricky:

• Were the study groups truly comparable at the start of the trial?
• Were the randomization and blinding done appropriately?
• What statistical methods were used to compare outcomes?
• If the differences were statistically significant, were they also large enough to be clinically meaningful?
• Were the patients studied comparable to people a doctor is treating or (as often occurs) healthier and younger?
• If the comparison drug was a placebo, how does the new drug stack up against all the evidence on other relevant treatment choices out there (perhaps including nondrug options) that weren't in the trial?

“Beyond all that, the issue of selective publication of favorable results has bedeviled all of us who look to the peer-reviewed medical literature to guide our decisions about how well drugs work, a problem several researchers have documented. A worrisome analysis of this issue was published in the New England Journal of Medicineopens in a new tab or window by Erick Turner, MD, a psychiatrist who had spent several years at the FDA reviewing new drug applications. While there, he noticed that the more favorable studies that crossed his desk were more likely to end up being published in medical journals than the less favorable ones. Once he left the agency, he and his colleagues followed up on the concern that drugmakers who sponsor studies have in the past published the results they liked and spent far less effort to get non-favorable trial findings into the medical literature. Turner et al. reviewed the raw data on 74 clinical trials submitted to the FDA evaluating 12 different antidepressants and found that almost a third of them had never been published. Virtually all those that depicted favorable outcomes made it into medical journals; but of the studies with negative or questionable results, nearly all were never published, or appeared with a positive spin on the results.”

Approximately 62% of Americans age 25 and older do not have a college degree, and college enrollments are declining. Even among college grads, business and liberal arts majors certainly lack the background to assess drug studies, even if they did have all the data. 

Only a middle school boy, a case of arrested development or a libertarian (but I repeat myself) would assert that Americans are competent to distinguish between effective medication, quackery and outright dangerous therapy.

https://www.medpagetoday.com/opinion/second-opinions/115722?xid=nl_secondopinion_2025-05-25&mh=eb71348a5ff6ae370cc6759bc5dc3300&zdee=gAAAAABm4u1YoCP4y5SBTJUyUyqo9KxZhft26L1xeGdP0BzzQQN1Pb_ifR6vFqhFh-3U6Q_nU7DbA-EawzzXKxSRhMOwjrOGuOKbf7OE641eN0HfnK6eObE%3D&utm_source=Sailthru&utm_medium=email&utm_campaign=WeekendOpinions_052525&utm_term=NL_Gen_Int_SecondOpinion_Active