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Every time we come to elections, you probably notice how attorneys are suddenly being debated. The GOP claims they are the spawn of the Devil. Their sole purpose in life is to put all businesses into an early grave. The theme is simple. Every mistake can be evidence of negligence and, without tort reform, we will all suffer. The Democrats sing the song that attorneys are the only thing standing between consumers and predatory businesses. This highlights two quite separate but important problems. First, we have become a very litigious society. If anything goes wrong and we have the money (or are insured), the first reaction to any loss is to blame others and sue them. Consequently, we have one of the most active court systems in the world. Second, there’s a real shortage of adequate laws to protect consumers. This encourages everyone to sue using the law of tort and there we get into long-running cases where attorneys make a lot of money.

Let’s move over to New Jersey where a case has just finished against Roche for their acne treatment. Three claims were heard together. They alleged the drug had caused serious ulcerative colitis. You probably read about this because several Hollywood celebrities were involved as plaintiff and witnesses. The result was a 2 to 1 win for Roche with two of the claims being dismissed by the jury. In reporting this, we can gloss over the fact there are some three-thousand similar claims outstanding. There’s a bandwagon effect. Once word goes around that there’s one claim, other plaintiffs suddenly appear. No matter what the merits of these claims, there are some instructive lessons from other countries.

In Europe, only a qualified dermatologist can prescribe this drug, and he or she is directly responsible for monitoring the progress of the treatment. Patients are usually required to attend the clinic or hospital once a month for a check-up. This ensures a lower risk the drug will be abused by the patients. There’s evidence US patients want the cure now and not tomorrow, so they decide to increase the dosage or extend the period of treatment. Without proper supervision, the drug can therefore cause more damage. The fact there are warnings in the literature given out with every prescription is not helpful. Few people ever read them from start to finish. In New Zealand, there’s very clear research evidence showing low dosages are safe and effective. Such evidence is unlikely to affect the behavior of our teens who are determined to have perfect skin no matter what the cost. Read the rest of this entry »

Over the centuries, we’ve been looking for a magic bullet to give instant pain relief. One of the earliest discoveries was based on the poppy. Depending on how the plant is processed, a range of different drugs can be produced. But there’s always been a problem – the extracts are addictive. Even short-term use can produce destructive consequences. When there were no alternatives, significant numbers of people were hooked, sometimes when only suffering minor symptoms. This led to increasing regulation and control as government grew concerned over the social consequences. The first steps were to make all the opiate drugs prescription only. This has never been a perfect system. Drugs always leak on to the streets when the rewards for illegal distribution are sufficiently high. But with the arrival of more effective alternates, it’s been slightly easier to control the level of addiction. Except control is never perfect. The death rates show more Americans die through the abuse of prescription medication than through the use of heroine and cocaine combined.

We’re the most heavily medicated group of people on the face of the planet. It’s a sad fact more teens experiment with painkillers than cigarettes. Yet every time a state or the federal government suggests tightening up on the prescription of painkillers, there’s an outcry. The libertarians among us believe we all have an absolute right to take whatever drugs we want. There should be no legal limits when the only victims are ourselves. So attempts to discipline doctors for overprescribing the narcotic painkillers often stall. It’s at this point the argument gets mixed up with the problems of end-of-life care.

There’s a strong view in many states that people should be allowed to die with dignity. This means, say, a cancer patient should be given high doses of painkillers even though this will accelerate death. The pro-lifers object saying this is murder, i.e. not death caused by the cancer, but death caused by the drugs. Yet, if lawmakers limit the use of these more powerful drugs without multiple exceptions, people who suffer chronic severe pain may be left without relief. Sometimes the pain from arthritis demands the use of the most powerful drugs. If the discretion of a doctor has been limited, many may be left in pain. Read the rest of this entry »