Friday, December 05, 2008

The Terror of Risk

It seems that the media is like the creepy Nazi from The Marathon Man who sorrowfully remarks that in the previous days torture they had killed the nerve in the tooth that he was using to cause the Dustin Hoffman character pain. He then continues that they would have to drill into a healthy tooth to expose the nerve so they could continue the torture.

What I mean is that the media is constantly bringing some low risk, next to impossible event or complication and hitting us with it so that we will a) pay attention so that we can avoid the horrible fate and b) advocate the removal of all risk of this ever happening.

Now there are some campaigns that make a lot of sense. I can remember when pretty much everyone drove around in cars without wearing seatbelts while smoking. The causality and probability of both seatbelts and smoking were pretty much well established. On the other hand the fear of terrorists, contaminants in our drinking water and food is pretty much a fabrication created by exposing the incredibly improbable as possibly happening to you.

The latest is toxic epidermal necrolysis and its association with fairly common medications. What they do not tell you is that the necrolysis only happens once in a trillion prescriptions. No, fear sells almost as good a sex. In this case there is an incredibly small risk when you take certain medications that your skin will fall off in a horribly debilitating and quite often fatal drug reaction (LINK TO STORY) . There is no doubt that the people who suffer this reaction deserve our support and sympathy but they should not be used as a fear tactic to remove perfectly good medications from circulation.

This is in fact the reason why so many drugs fail in trials. There are many drugs that have been tested and have worked well for common conditions. The problem is that one in a thousand or one in five hundred patients will have an adverse reaction so the drug is withdrawn. We need our medical societies to step forward and set or recommend proper regulations for drugs so that as long as adverse reactions fall below a certain threshold (I'd say one in a thousand would be OK as long as I am not the one) the pharmaceutical manufacturers would be protected.

I don't know that pretty soon we will be chewing on willow branches and rubbing eels on our warts if we don't start accepting a certain level of risk.