Ballot Initiatives

Stuff Your Faces with Experimental Drugs, Dying Arizonans!

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"Pills or death?" "Um … I'm gonna go with the pills."
credit: epSos.de / photo on flickr

This week Arizona joined Michigan, Colorado, Louisiana, and Missouri when voters approved a "right to try" ballot initiative allowing terminally ill patients to experimental drugs or medical treatments that have passed early stages of clinical trials but are not yet formally approved by the Food and Drug Administration.

It seems like it should be a no-brainer (and it was, passing with 78 percent of the vote). As our Nick Gillespie has noted: "You don't have to be a doctrinaire libertarian—though it helps—to see the value in letting people with nothing left to lose experiment on themselves. They may get a new lease on life. The rest of us get meaningful information that may speed up the development of the next great medical intervention."

Nevertheless, The Washington Post has sought out critics of this silly idea that dying people should be able to try whatever they want as long as it doesn't hurt anybody but themselves:

Critics of the "Right to Try" laws say these unproven treatments could hurt patients and the drug development process. Further, the drugmakers don't have to provide these treatments, and there are reasons why they might not want to, including liability concerns and a lack of supply early into a drug's development. And insurers don't have to cover the drugs.

New York University bioethicist Arthur Caplan has criticized these laws as a "feel-good" effort that doesn't tackle the main problem — being able to afford these expensive treatments. That goes for the families who want to pay for the drugs, and the small companies funding the lengthy process of getting a drug to market.

These are rather odd criticisms that seem to boil down to: "Acknowledging that a terminally ill person has a right to try experimental drugs doesn't actually obligate anybody to provide these drugs, therefore it's no good." The only choices to them are apparently bans or mandates. The patients not able to get these drugs at all now. It's absurd to complain about equality of access when the current outcome is that nobody gets any of it, except for those who turn to the black market. This is similar to complaining that selling birth control medication over the counter rather than through a prescription doesn't really count as improving women's access because women would still have to pay for it.

In any event, Arizona voters obviously realized there was no point of making perfect the enemy of the good when people were dying. Perhaps more states will join in.

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  1. Try using more verbs when you writing.

  2. Would bioethicist Arthur Caplan be OK with tackling the real core causes here: reining in the FDA so that it doesn’t cost a billion dollars to get a drug approved, and reining in the trial lawyers, so everyone wasn’t so worried about liability?

    1. That wouldn’t be bioethical.

      1. I think the “ethics” component of “bioethics” is meant to be read ironically.

    2. And I don’t understand his argument. The FDA flat out forbids people from taking the drugs without their going through the approval process, correct? So saying people can’t afford it seems to me to be avoiding the real issue.

      1. Incorrect. The laws forbid people from supplying the drugs. They’ve always been allowed to take them.

        1. someday soon, 3d printers make the drugs.
          You pay the company for the blueprint, insert blueprint into printer.
          insert raw material.
          ?????
          profit

  3. “Stuff your faces with experimental drugs”

    Way ahead of you

    1. Just another Thursday afternoon around here.

    2. Jeez, all that time I was supposed to be terminal?

  4. These are rather odd criticisms that seem to boil down to: “Acknowledging that a terminally ill person has a right to try experimental drugs doesn’t actually obligate anybody to provide these drugs, therefore it’s no good.

    Hey Scott, you know how I know you’re not a credentialed ethicist?

    You raise objections like this.

    1. And the mindset here is the same as we see in the attacks on charter schools, vouchers, and homeschooling–collectivists are afraid that if any of us make a move to get out of the sinking ship, there will be less incentive to save it. Therefore we prevent people from getting out of the ship, consequences be damned.

      You gotta see the big picture.

      1. The irony here is that, by allowing people to “get out of the sinking ship”, it will increase the buoyancy of that doomed vessel, thus, allowing those who escape an alternative opportunity to survive while also allowing those who remain in the ship to stay afloat that much longer.

  5. The FDA is certainly holding back the innovation of new drugs. But most countries follow the ICH E6 which was enacted after the Nazi’s performed research on un-willing participants. There is language in the ICH E6 that says terminally ill patients are considered easier to coerce, so that MAY be a reason why there is reluctance to allow terminally ill patients to try experimental drugs. That said, its still BS, this shouldnt even be an argument. And why did the FDA stop the clinical trials on Ebola vaccines 3 months after the outbreak in Africa…hmmmmm….

  6. While I find the title of this piece unfortunate, the content is important. As an Oregonian I already have the “right to die” using our Death with Dignity act; I should also have the “right to try” drugs not approved by the FDA. I’ve already starting contacting Oregon legislators looking for “right to try” bill sponsors.

    1. The effect of such state laws is going to be pretty slim. For one thing, as I’ve written, people have always had the right to receive and take drugs except for controlled substances and human growth hormone; few experimental drugs are going to be in those classes. For another, an experimental drug that’s passed phase 1 trials, as the “right to try” laws require, is almost surely going to still be an investigational drug being tested under protocols approved by FDA, which aren’t going to allow distribution to those not in clinical trials. The only way “right to try” has an effect is if the drug maker is in the same state and has given up at least temporarily on trying to get the drug marketed nationally. And that’s if the drug maker has no liability insurance & no assets that a tort lawyer could sue for.

  7. The electoral outcome in Arizona was a mixed bag.

    We approved this “right to try” ballot initiative.

    We failed to approve the initiative that would have outlawed pension spiking in Phoenix, and would have put new employees into a 401 (k)plan.

    And we agreed to massively tax ourselves to spiff up the county hospital, despite the fact that a private hospital had offered to run the trauma center and burn unit at no cost to the taxpayers.

    I love the ballot initiative process, but hate that people are so easily convinced to tax themselves and others. Take the good with the bad and all that…

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