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The Evil of Medical Licensure (and the FDA) - Open Knowledge — LiveJournal

Oct. 8th, 2006

03:15 pm - The Evil of Medical Licensure (and the FDA)

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Check out this sobering account of one woman's futile efforts to buy emergency contraception. The fundamentalist Christian mindset deserves the scorn it receives in the comments. But nobody seems to recognize the two secondary villains, without which the fundamentalists would not be able to exert their pernicious control: medical licensure laws and the FDA. Both institutions were instituted by liberal do-gooders (in collaboration with established industry players) who wanted to "protect" the ignorant public from quacks and charlatans. Yet another example of how people think that _their_ guys will always be in control, and the laws they pass won't be used against _them_.

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From:dorei
Date:October 8th, 2006 04:04 pm (UTC)
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and according to later entries -- she conceived that day.
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From:pentomino
Date:October 8th, 2006 04:49 pm (UTC)
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It seems the only hack to this one is one that's a good idea to begin with: find a way to get it in advance of needing it.
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From:crasch
Date:October 9th, 2006 02:41 pm (UTC)
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Yes, I agree, that would be the smart thing to do.
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From:pentomino
Date:October 8th, 2006 05:07 pm (UTC)
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BTW, the FDA has done a great job making it difficult to get just about any medicine that works. But there's homeopathic medicine, which never works, freely available to all at every Whole Foods.

One of these days, someone will start selling homeopathic Morning After pills.
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From:smandal
Date:October 8th, 2006 07:16 pm (UTC)
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Homeopathic medicines are harmless for the same reason they're useless.
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From:mindwalker
Date:October 8th, 2006 05:29 pm (UTC)
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Well, at least a few of us recognize those secondary villains. I'd probably even consider them the primary villains.
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From:crasch
Date:October 9th, 2006 02:42 pm (UTC)
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Well, I agree. But if you're on my friend's list, I expect that you're atypical in that regard. :>
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From:ricevermicelli
Date:October 8th, 2006 07:05 pm (UTC)
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Well, in nearly every respect, she carries all the blame for what happened. Sex creates kids and when it doesn't, that is an unusual exception (from a biology standpoint).

No it doesn't. That's what they teach us in health class, and if you don't want to get pregnant, you are best off behaving as though you believe that particular statement 100%, but there are only about 24 hours in any month during which it is even possible for a woman to conceive a child (pinpointing those 24 hours is hard, and sperm survival complicates the issue, but still - only 24 hours). A couple who has frequent, unprotected sex during the course of one menstrual cycle has a 20 - 25% chance of conceiving during that cycle. And then, nearly a third of all pregnancies end in miscarriage, usually before 12 weeks, but often even before the woman knows she's pregnant. For something that happens as often as it does, conception is a pretty rare event.

The most common version of the oath that doctors now take does not mention preserving life, which is a problematic aim in some areas of treatment (blindly preserving life has horrific consequenses in geriatric medicine and the treatment of terminal diseases). The relevant phrase in the oath most medical students take is: "If it is given me to save a life, all thanks. But it may also be within my power to take a life; this awesome responsibility must be faced with great humbleness and awareness of my own frailty." (Complete text available here.)

Pharmacists most certainly do *not* have the same discretion as doctors regarding prescriptions - my doctor has my complete medical history, and has discussed my circumstances with me. The pharmacist is not privy to the same information.
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From:crasch
Date:October 8th, 2006 07:06 pm (UTC)
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P:hysicians and pharmacists have legal monopoloy on drug dispensation. While I agree that they should not be forced to aid in what they believe to be an immoral act, I also believe that they should not have that monopoly in the first place.
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From:papertygre
Date:October 9th, 2006 07:26 am (UTC)
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I'm confused that she didn't look any farther out than her phone book had telephone numbers (was it 100 miles?). When I lived in Pittsburgh, PA, it was only about a 3 hour drive to Cleveland. Wherever she was in Ohio, surely it would take under 5 hours to get outside the state, and if it meant not getting pregnant I'd drive that far.
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From:papertygre
Date:October 9th, 2006 04:03 pm (UTC)
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The more I think about it, the more I think she didn't exhaust all options available to her. (a) Why didn't she use a backup method like foam? I think she said she couldn't use a diaphragm, but she could still use foam AFAICT. It's not that effective compared to anything else but it's better than nothing. (b) I got plan B once and it was via an online site that dispensed EC prescriptions within 12 hours. Apparently this website had some kind of licensed MD who wrote prescriptions in return for a credit card payment and an affirmation of intent. I don't know how legal this was, but it worked -- the local pharmacy filled it. I didn't even know at the time this option was available, but searching around for "Plan B" turned it up quickly in the search ads. Since I've never heard of it again since, I'd be surprised if this practice had been completely stamped out in the 2 years since I took advantage of it. (c) EC is nothing but a high dose of birth control hormone. If she recently quit the pills, she should still have some left over, and she could probably find out what the dose is in Plan B and take the equivalent in birth control pills, as a last resort.

Don't get me wrong, I agree that it's outrageous that local medical authorities were able to use their personal beliefs to interfere with her attempts to get the treatment she was seeking. I also think you're right that the people who set up systems of regulation never seem to consider the ways in which it could be abused by people who have different agendas than themselves. But being a computer nerd, I can't help but think it's a security problem more than anything. Legislators should have training in operating systems, and I really think there should be a 'legal compiler' that checks proposed laws for loopholes, unexpected side effects, and contradictions with existing law.

And I don't know if it's a realistic solution to want to abolish all medical regulation, if only because of herbaliser's point about antibiotics above. As a society, we can't help affecting each other: your reckless behavior affects my insurance premiums; my use of pesticides affects your fields next door. So it sucks when someone else has strong moral views that I disagree with, and manages to sneak some of them into law (or even just de facto law). But, and maybe this is pessimistic, I think it's not a phenomenon we can just end in one stroke; I think it's a fundamental and recurring problem inherent in the practice of humans governing themselves.
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From:crasch
Date:October 9th, 2006 07:01 pm (UTC)
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As a society, we can't help affecting each other: your reckless behavior affects my insurance premiums; my use of pesticides affects your fields next door.

That's true. The question is whether government regulation is the best way of handling that problem, or whether it introduces more problems than it "solves". How do you think that the efficacy of the FDA/medical licensure should be measured?
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