Letters to the Editor
ondelette
Published Letters: 1988 Editor's Choice: 19
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Who decides the impact on the public health?
[Read the article: Brit Hume is a "journalist"; Keith Olbermann is "partisan"]
[Read more letters about this article: Here]The problem with your argument is that it doesn't work. In a system where you make your own choices except in the case of public health, you will eventually (with some people quite quickly) get conflicts because you have decided to appoint an arbiter for the determination of when your medical choices affect the public health. Your arbiter is yourself. Your choice of who decides you are competent is yourself, as well.
Addiction is a public health issue, as are the complications caused by it. Emergency medical services are a public health agency, and when you become incompetent needs to be judged by those people, not yourself. When you become a danger to yourself or others, that is a public health issue. The spread of disease is a public health issue, the spread of medical information is also a public health issue, the quality of medication is a public health issue. The cost of your health to the system is also a public health issue. Whether side effects of the drugs you take can cause impairment that endangers others is a public health issue. Whether those side effects make you susceptible to disease that the public needs to have controlled is a public health issue.
When you go to the physician and demand to take a scheduled drug, and the doctor cites addiction and need, and you make your (actually Glenn's) comment;
Why should your judgment prevail over mine for what I take? Why, as a competent adult, should I need your permission before I can take the substance I decide is best for me?
What do you say when the doctor tells you there is a public health interest involved and your failure to acknowledge it means you are neither informed nor competent to make the decision? Argue that you are, because you know about antibiotics?
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@Mona
[Read the article: Brit Hume is a "journalist"; Keith Olbermann is "partisan"]
[Read more letters about this article: Here]No, I don't think so. Your response is telling, I never mentioned the public purse, nor would I. I mentioned the public health. But while we're on the subject, I have some view that personal health needs to be subject to some expertise as well.
Not so long ago, weeks, not months, I held a guy's head in my hands for a very long time. I didn't want him to move it, and I didn't think him competent to tell me otherwise -- which he did vociferously. I didn't bat an eyelash about the freedoms you are so "scared shitless" about. I just kept holding his head and telling him, as often as he told me his opinions on the subject, not to move.
You know what? I don't really care whether or not when he got to the hospital and they checked him out they found out he was okay. I don't care whether he hates me for ruining his day, or costing him money, I don't care whether you think I trampled all over his libertarian freedoms. I don't even care whether or not he eventually sees that what I did was the right thing to do, or whether or not you think I should have stuffed my head in a bag of sand.
I was competent to make the decision, he was not.
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@WT
[Read the article: Brit Hume is a "journalist"; Keith Olbermann is "partisan"]
[Read more letters about this article: Here]No, of course not. We have some regulations, we have some procedures, we don't have others. But it really isn't the case that a person can make an informed and competent choice about everything, all of the time.
There's a world of difference between saying that society should tell a diabetic what to eat (although I do believe someone should try to persuade them about a few things for their own good), and letting someone prescribe their own antidepressants.
And public health is a concern. If a woman comes up to me and says "my child has a splitting headache", do I have the right to ask the child to touch her chin to her chest? Even if the mother thinks it is irrelevant? Suppose the mother thinks that seems incompetent or is a conspiracy to cause some syndrome she read about on the internet?
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@WT @jojo++
[Read the article: Brit Hume is a "journalist"; Keith Olbermann is "partisan"]
[Read more letters about this article: Here]Okay, I'll bite. Actuarial tables and risk/benefit analysis is useless unless you are aware of all the risks and all the benefits. But in the case that you are, then informing someone of the probabilities in the table is completely informing them of what they need to know to make a competent, informed decision.
Not everything is reduced to such tables, nor can every decision be framed in terms of an exhaustive list of risks, their concommitant benefits, and a simple choice. If it were, we could let computers running Bayesian analysis make all our decisions for us. There are bodies of knowledge that don't reduce that way, and you may have to rely on an expert to make a decision (and that's all long before we get to Godel). Should you have as much choice as possible? Sure. Should the expert be someone you can vet in some fashion? Sure. Should accumulated expertise be encoded in laws, guidelines, protocols, and in some cases, the permanent vesting of decision making authority to a trained group of experts? Sure.
This is not to say that eternal vigilance isn't needed to protect freedoms, nor that secrecy and privilege are good. It isn't even to say that drug laws or medical systems (or journalistic procedures) shouldn't be debated and discussed. But it has been over 100 years since scientists and experts have even been able to know all of their own fields in many subjects. It is unreasonable to devise a system that relies on individuals to make decisions requiring expertise based solely on informing them in the moment. They need to be protected from excessive decision making, from conflict of interest, from bad decisions, and all the other things experts can do, but do you really want to try to be expert on everything that affects you in a 6 billion person highly technological world, and "oh, well!" if you get it wrong?
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Sorry,
[Read the article: Brit Hume is a "journalist"; Keith Olbermann is "partisan"]
[Read more letters about this article: Here]sufficient risks and sufficient benefits. I got carried away.