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Public Citizen Cares About Me

February 23, 2007

Tags HealthInterventionism

And every other woman in America. So much, in fact, that they want to be sure we don't have a chance to make what they consider to be bad choices about contraception. The organization is petitioning the FDA to ban newer-generation birth control pills on the basis that they "offer no unique benefit over the older and safer pills." This illustrates a key problem with the winner-take-all governmental approach to drug safety that the FDA represents. First, it treats "safety" as though it were an objective standard and an objective concept. It's not. All drugs have risks and benefits. The individuals who make up the group Public Citizen believe that the risks of the newer generation of birth control pills outweigh the benefits. There is nothing wrong with that belief in and of itself, nor with their conducting an educational campaign to tell other people so. The problem is their failure to recognize that risk-benefit assessments are subjective and unique to the individual.

By forming a lobbying group, they can make their subjective preferences into regulation that is binding on huge numbers of other individuals. Having their beliefs enacted in regulation does not make them an objective for juding the safety of drugs. It simply means they gamed the system to get what they wanted. Whether the risks of certain pills outweigh the benefits depends on the woman assuming the risks and enjoying the benefits. But through the petition process, Public Citizen can claim the right to make that decision for every single woman in America who uses or is considering using oral contraceptives, based solely on the subjective preferences of the individuals who make up Public Citizen.

The FDA, by law, has to consider their petition, and therefore must seriously consider allowing a small group of people whose sole interest is lobbying the FDA to make an important decision for a huge, diffuse group of people who spend little time paying attention to what the agency does. The result could be a sweeping, one-size-fits-all solution that does not take into account the diverse preferences of individual women, or the subjective risk-benefit analyses we all do when deciding whether to use pharmaceuticals. A petition like this is emblematic of what is wrong with governmental control of drug safety. It makes no room for the diverse, subejctive preferences of individuals, decreases our choices, and deprives us all of the benefits of medical progress for the sake of an illusion of "safety".

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