Nonmaleficence Conundrum

If you watch television, you can’t avoid hearing about how this pill or or that salve will miraculously cure your headache or skin rash or allergy, as long as you don’t mind a small risk of coughing up your lungs while convulsing and popping blood vessels in your brain. The warnings required by law in drug advertising are so dire that people make jokes about them, because taking them seriously would foster the worst kind of paranoia. (Somehow beer ads are exempt from such encyclopedic caveats; although alcohol is certainly a dangerous drug, it’s one we’re used to — and we still remember what happened when we tried to prohibit its use.)

Now I read about a study (see Wells & Kaptchuk) that shows how these warnings trigger a nocebo effect (see the eponymous Rant on this site): patients who are warned about possible side effects in the name of informed consent are significantly more likely to experience said side effects than those left blissfully ignorant.

It follows as night the day that all those warnings on TV about possible serious side effects are actually causing more such effects in the millions of viewers being warned. The legally mandated caveats are actually killing people! Surely the deep pockets of the pharmas are funding massive legal action to strike down these laws; if not, the first lawyer to think of it is going to make a lot of money.

Is there no way to retain the requirement for full disclosure without making more people sick? Sure there is: just provide all the information. Tell us how likely each of the side effects is; that information must exist, or it would be hard to justify requiring the warnings. The only problems are (a) viewers would have to acquire the wit to distinguish between a little and a lot (see my Rant on “Quantitacy” here) and (b) the ads would be several minutes long, unless the announcer learns to talk even faster!

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