Johnson and Johnson, America’s Most Admired Lawbreaker
highline.huffingtonpost.com
highline.huffingtonpost.com
The most interesting aspect of the story for me is how the company's culture has changed for the worst over time.
Johnson & Johnson was started and for many decades was run by sincerely idealistic do-no-evil entrepreneurs, who wanted to focus on "patients first and profits last"... but now this business is run by executives who seem to be doing the exact opposite while claiming to abide by the same values.
This is a huge challenge for successful founders: how does one ensure that a company's culture and values don't degrade long after the original team is gone?
The author, Steven Brill, a successful entrepreneur and writer[1], wrote another powerful long-form article about the insanity of healthcare bills in the US a couple of years ago:
http://time.com/198/bitter-pill-why-medical-bills-are-killin...
Highly recommended if this is of interest to you.
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More than just a founder problem. This has been a defining problem for empires throughout history: how to make sure the next guy doesn't mess it up.
In another way I'm also reminded by the family companies (hotels?) in Japan that have been going for a thousand years, where they adopt grown people into the family to continue the family business.
Another thing is that somebody needs to go to jail. And it should be from the top of the chain to the bottom. If you're a sales rep dealing with pamphlets which you've explicitly been told can't be left out in case of regulators, your options should be "whistle blow" or be held accountable along with the rest of that chain.
In a country with over two million people in jail you'd think we could nail one of these bastards. It's just so gross.
Then there's all the issues with the US Taxpayer directly funding vast amounts of the research that goes into these pharmaceuticals and not receiving anything in return (except for exorbitant unregulated health care costs). The taxpayers need to benefit from the corporate profits which come from taxpayer funded research.
I'm not exactly sure what to think about all the advertisements for drugs on our tvs and to our doctors. Most of me thinks it's disgusting. I'm not one to think there should be a profit motive in healthcare as it can lead to awful stories like this (I'm done with chapter one, I figure I can do one a day). Unfortunately these are, at the moment, opinions, and I can in no way fully flesh them out, offer concrete evidence as to why it should be any other way, or really truly expand on the issues. That'd be a post of it's own and a few weeks research I think.
Something needs to change though.
And this is important because the doctors rarely have time to do research on the samples that they were given. So its sort of a good thing to give the doctor as much info as possible but this rarely happens as pharma sales person Barbie and Ken could care less.
Pharma sales have strict compliance but guess who enforces those compliances? The pharma companies. Not the FDA. So guess what they use the compliance issues for... to get rid of older employees or to screw over other companies (ie tattle telling).
Its completely fucked up.
Maybe back in the old days, but now with instant journal access, instant press access, etc its really not an excuse.
Self-compliance and regualtion isn't all that terrible especially when the alternative is underfunded and politically controlled organizations like the FDA. We like to believe in this myth that they're above the fray when it comes to commercial and political interests, but that's just not true. The FDA has no shortage of whistleblowers.
This attitude of "OMG IF ITS NOT 100% SOCIALIZED ITS SHIT" is extremely questionable. I don't know why its taken up uncritically on internet forums. One of the nice things of US society is that we have a more sophisticated idea of public/private partnerships which leads to interesting outcomes. This builds a lot of flexibility, creates investor confidence, and is just better business. For example, why are all these miracle drugs from the US and not from, say, Greece? Its clear there are many, many advantages to the US system. Silicon valley wouldn't have existed in a high regulatory environment, yet here you are on a forum dedicated to technology startups largely centered in that area and derived from that culture.
Not to mention all the academic research on the success of open markets, low regulation, etc.
The US doesn't have to do anything like that. We don't even need foreign oil as much as most countries do.
1) Strong rule of law 2) Political and economic freedom 3) Regulations that focus on reducing information asymmetry.
There are plenty of examples: America, Canada, parts of Europe, Chile, South Korea, Japan, Australia, New Zealand. The rapid development of Eastern Europe (particularly Poland) is a great case-study.
But this simple truth is a threat to a lot of entrenched interests, who will fight and deny it every step of the way.
This isn't correct. Sales reps main role is promotion and the FDA has jurisdiction over drug promotion. There are been several examples of the FDA coming down hard on companies where drug reps fall outside of regulations.
In fact, most of the non-compliant behavior is reported to the FDA by other competitors? What better way to hammer your competition than to rat them out to the authorities?
I would say almost all of the compliance issues are sales reps forgetting to get signatures or getting the wrong signature. This is not what the other pharma companies tattle tell on as its a minor issue that is waste of time for the other pharma company to go to the FDA with.
Lets say the pharma company is unrolling a new drug or wants to try new sales tactics.. they will use use the signature compliance issue to fire sales reps. They will threaten the employee that they can report them to the FDA. Bare in mind that they collect these electronic signatures. And this is a serious termination that benefits the company since they don't have to pay various taxes (as opposed to laying off people).
I'm just curious refurb are you in the industry? I could be wrong that this is done by all pharma companies and this was just an isolated issue (ie bad apple).
A list of the $13B in fines paid by pharma companies just in 2009 to 2014: http://projects.propublica.org/graphics/bigpharma
https://projects.propublica.org/d4d-archive/companies/johnso...
How is this legal? I'm ignorant of the details but for instance, if you click on California and look at Speaking, top of the list doc got $86,550!
This is again, not necessarily evil -- in fact, it's a logical continuation of the law which mandates that companies only promote their drugs exactly and only for what FDA regulations approved the drugs for. The problem, as presented in the OP, is when doctors unofficially (i.e personally) endorse/promote/heavily prescribe drugs for off-label uses. Again, not an illegal thing on its own, as doctors are trusted to prescribe what a patient needs based on their professional judgment (or else, Dr. "House, M.D." would be in prison)...but the worry is that a financial relationship with a company (i.e. the payments for touting the official line) have the potential to taint a doctor's professional judgment.
[disclosure: I used to work at ProPublica and on the Dollars for Docs project]
[1] http://www.propublica.org/article/double-dip-doctors-paid-to...
When I get a prescription from a doctor I have no idea whether or not he is getting something out of it. Whether it be speaking fees, a new pen, lunches, or whatever. Legal or not. I just trust that that doc is acting in my best interest.
And thank you for the work on the Dollars for Docs project. I for one am appreciative of this find.
I believe that in places with centralized healthcare systems, there are people who are responsible to understand the new drugs, both at the level of the healthcare provider and the health ministry - and they guide doctors on what to prescribe.
This makes sense because they don't have a conflict of interest(unless bribed).
"The government investigation of Risperdal sales later unearthed one email from a Johnson & Johnson salesperson that was typical of the approach. She told her supervisor that she was going to promise one doctor that if he raised his Risperdal market share from 16 percent to 50 percent in the coming 12 months he could become a paid speaker."
On topic (again only got through chapter 1) I hope that J&J, or better yet those actual PEOPLE, that were involved get punished. And not the that's the cost of doing business punished. I doubt it but one can hope.
J&J spent a lot of time and a ton of money to bring a new drug to market, sure, but the only apparent improvement over the previous generation is their own revenue. It's hard to believe this is an isolated incident.
From their about page:
"It's a new digital home for an old journalistic tradition. Think of it as a magazine that only runs cover stories—big, ambitious pieces intended to change the way you see the world or influence the course of policy. Investigations will take months, essays will be finely considered, the subjects we choose to write about will feel urgent and essential."
The Food and Drug Administration had prohibited Johnson & Johnson salespeople from trying to promote Risperdal to doctors to treat children because of its feared side effects, including hormonal disorders. The company was also not allowed to promote it to treat the elderly except for the most serious psychotic disorders; it was thought to cause strokes, diabetes and other ailments in that population. But [...] Johnson & Johnson was reaping more than half of its Risperdal sales from prescriptions written for children to alleviate all kinds of behavior disorders, and for the elderly, who were given the drug for simple symptoms of dementia or restlessness.
Johnson & Johnson emails, sales training manuals and business plans produced as evidence in the case revealed that the company organized special sales units illegally targeting doctors who treated the elderly and children. State mental institutions treating children, whose drugs would be paid for by Medicaid, were targeted, too.
When it came time to explain their conduct at trials and to federal investigators, Johnson & Johnson executives and salespeople have unwaveringly, even indignantly, defended themselves. One salesman, who otherwise fit the salt-of-the-earth mold that R.W. Johnson had envisioned for his company’s employees, gave thousands of Risperdal samples in child-sized doses to Austin Pledger’s doctor in Birmingham, Alabama. Yet he insisted under oath in February he didn’t recall stepping around kiddie furniture and toys as he walked into an office with a sign that said “pediatric neurologist,” and that he had no way of knowing that the doctor wasn’t treating adults.
J&J pushed their dangerous pills aggressively, illegally, and unapologetically. They targeted children and seniors.
http://www.amazon.com/Blood-Medicine-Blowing-Deadliest-Presc...
This book is totally gripping and it also sheds light on the EPO scandal of the cycling world. I do not recommend books lightly but this book is a must read and also a literary 'secret' that is going to be made into a film. Add it to your Christmas list.
I read it a while ago with my Dad reading it too. It was the best thing we read that year - happy times, a book club of our own. Needless to say I have sent this article on to him for his enjoyment.
Is it just me or does this kind of attitude make you say "F* YOU Wall Street".
Thankfully the numbers are quoted which lets me form what I think is a better opinion.
I myself am an anti-anti-vaxxer (a pro-vaxxer?) who actually supports state-mandated vaccinations, but this puts me in the very uncomfortable position of having to defend one corner of an industry that does the kinds of things described here and a government that has failed at the most basic oversight.
So the next time you read about a measles outbreak at a theme park or you see a scientifically illiterate ghoul like Jenny McCarthy peddling her child-killing nonsense on TV, spare a thought for Johnson & Johnson, because they're feeding the anti-vaxxer paranoia and kneecapping legitimate public health efforts.
I am not an anti-vaxxer. I was vaccinated. I had my children vaccinated.
I just hold the position that the power of the state shouldn't be used to compel people to inject substances into their bodies, even if we think we have a good reason for doing it.
I'm not looking to delve too deeply into the politics of it but there are good reasons to oppose mandatory vaccinations.
Also, once you give the government the authority to require people to be injected, they will probably start expanding it in various directions. That's really not a power I want to give to them.
And a child who is not vaccinated by their parent may want to get that vaccination when they're old enough to make that decision by themselves.
(And yes, the "anti-vax" "movement" is disgusting - a fine example of the stupidity of crowds. Unfortunately, defending freedom often means defending scoundrels).
There's a similar argument around fire coverage. The common argument against a more libertarian approach to fire fighting is that if someone's house catches fire and is left to burn, then it will easily spread to neighbors, increasing their risk. And this the obvious physical reality, especially where things are dense.
But since those neighbors are the only concerned parties, then why (in principle) is that additional risk not theirs to bear and mitigate? It cannot cost any more than the neighbors splitting the cost of the fire protection on the unprotected building. Practically, the fire department would just pool that overhead across all customers.
Of course there is the issue of long term second-order effects - freeloading - since most likely if you didn't pay the fire department would still try to extinguish your house as quick as possible (possibly just busting it up a bit more in the process). But making coverage mandatory also ignores long term second-order effects when an organization does not have to be responsive to the people it serves (which is usually then handwaved away with the wisdom-of-crowds fallacy).
The root of the disagreement comes from different thinking about what society actually is. Is it a monolithic system we're all bound to and the only way to change it is top-down? Or is it the constructive result of the surplus that everyone is willing to bring to the table, implying that an individual should have the option to quit the game and take their ball - even if that individual then watches from the sideline or even returns to play but without their ball?
Both perspectives are needed, but every society is predisposed towards over-centralization - most people have a very hard time seeing anything besides their own perspective, so they falsely think their desires apply to everyone. Yet as demonstrated by the success of free markets, only decentralization can satisfy and incorporate minority viewpoints. When creative destruction is prevented from applying to structures within the society, then it will inevitably occur to the society as a whole.
I don't see how you can argue that it ignores this in the case where people advocating for mandatory fire protection coverage advocate that the agency through which the fire protection is provided be democratically accountable to the people in the covered area, which pretty much excludes anyone advocating public coverage in the modern developed world; addressing that effect is a central purpose of democratic accountability.
> (which is usually then handwaved away with the wisdom-of-crowds fallacy).
If either markets were perfect or centralized control (in this case via democracy) were perfect, we wouldn't be having this discussion.
So yes democracy does create a connection between centralized government and the body politic. It's just a bit of a tenuous connection that addresses only gross problems that are understood (the inherent limitation of any centralized planning) by more than 51% of people.
Like maybe read just a tiny bit about them first?
Vaccines are not 100% effective, and, in any case, even if they aren't, they may have a real medical reason for not vaccinating: a large part of the reason for efforts to achieve universal vaccination among those who don't have a special medical condition making vaccination unavoidable is herd immunity; the effect that reducing the rates of infection reduces the risks from vaccine failure in those who do vaccinate, and reduces the risk of exposure in those who legitimately cannot vaccinate.
Nope, they really don't.
The default should not be for the state to force someone to inject a substance into their body, and if they refuse or raise concern, that it is then on them to explain/justify why NOT. The state should justify why they're doing it, and make a good case to each individual so they make the right choice.
If you think the first amendment is an important right in the US, then the right to not have complex chemicals and or living organisms injected into your body should be an even higher right (since you're entrusting your very health on the state).
I fully support vaccines and we are CHOOSING to vaccinate our kid. I understand herd immunity, but your fear doesn't trump other people's individual rights.
I dislike both anti-vaxxers AND forced-vaxxers. One is scientifically ignorant and the other is morally bankrupt. Pick your poison I guess.
Ultimately it is the fact that vaccines AREN'T required that forces the government to spend the time, resources, and effort promoting vaccines. Without that they can just arbitrarily start demanding we inject things and outright reject all requests for information/data/etc.
We are actually in a good-ish place. Most of the population is vaccinated, there's plenty of data on vaccinations available to the public, and many of the concerns have been debunked using good solid science which cannot easily be refuted.
Essentially the forced-vaccination people are arguing for worse science, they just haven't figured that out yet because they aren't looking far enough into the future. If they are forced, what is the justification for the science? Or are you just going to rely on other countries where it isn't mandated for the science (in particular follow up studies)?
As the parent of twins born the day before the third trimester, I assure you my motivations here are not petty.
> Even assuming liability, you cannot sue dead people back to life, or sue an epidemic away.
Negligent homicide is punishable both civilly and criminally in most other situations. Why not in refusing to be vaccinated?
> We are actually in a good-ish place. Most of the population is vaccinated, there's plenty of data on vaccinations available to the public, and many of the concerns have been debunked using good solid science which cannot easily be refuted.
And we're finding that a certain percentage of the population is immune to scientific refutation. They're not going away, and they're causing some areas to drop below herd immunity levels. http://www.washingtonpost.com/news/wonkblog/wp/2015/01/27/ca...
Because it doesn't actually do anything with the problem of there possibly being an outbreak of some disease with the potential for widespread death.
Okay, great, you can hold the one person accountable for not vaccinating their kids liable for the deaths of ten people. Fantastic. Ten people still died.
Our justice system is very much a "If X, then Y" system - but what if your goal is not to deal with X the consequences of X, but to prevent it in the first place?
You could argue the deterrent effect, but if someone is irrational enough to ignore the conclusive logic that vaccines prevent you from getting sick, they're probably not going to be much more convinced by a (low) possibility that they might end up in front of a court and possible face prison. (And that's even if it can be proven beyond a reasonable doubt that the one person not getting vaccinated was the direct cause of the deaths beyond a reasonable doubt)
I think it's pretty fair actually - I don't want anyone (particularly children) to be forcibly vaccinated. But people should realize that choosing not to be vaccinated may cause harm to others and in that case it seems fair to be able to obtain compensation via the courts.
Therefore, all you have left is deterrent, but really, do you think an anti vaxxer would care about going bankrupt, vs their perceived chance of their kid getting autism? I'd be very surprised if it provided any deterrent at all.
I agree.
> The state should justify why they're doing it
And they do: herd immunity, which is supported by convincing scientific evidence.
I didn't say liberty should be violated by default. We are no longer in a default position -- the argument has already been made and it is apparent that vaccination is justified as a social good. As a member of a society, sometimes social good takes priority over individual liberty. My argument is that if people still want to reject it, they need to explain why their liberty should come before others' health. (This is a rhetorical request I don't expect someone will be able to convince me of, though some may hold this view.)
That said I'm not an anti-vaxxer, but I'm medically unable to take most of them now as they would dramatically increase the chance of a deadly side effect. Once in my life was enough (and the 6-figure hospital bill after insurance cap), and a 5% chance of reoccurrence is bad enough without tempting fate to make that risk much higher.
Conversely, you have no right to infect other people (this is a unconsented harm inflicted on others, the most basic thing that is a violation of rights.) To the extent that doing so is neither intentional, reckless, nor negligent, you also shouldn't be held responsible to prevent doing so -- the question with mandatory vaccination largely boils down to whether failing to use particular vaccinations without a special medical reason is such a failing of a duty of care.
Even most "mandatory" vaccination regimes don't generally do this.
They require people to vaccinate themselves (or, most often, their children) if they are medically able to be vaccinated as a precondition of use of certain public accommodations, as a means of protecting the health of other users of the same accommodation, including especially, but not exclusively, those medically unable to be vaccinated.
So there are some good reasons why I think you're right.
I happen to believe in both liberty and public health.
In practice, vaccinations against infectious diseases need to hit certain percentages, not 100% of the population. With free vaccination, post natal health care, school programs and public education campaigns we can hit those numbers, and we do so regularly.
There's no need for the gross violation of freedom some people fear, locking up parents or declaring them unfit, tying people to a chair and needling them. Doing this voluntarily puts more onus on the system to be smart and high functioning, invest in education and making people comfortable with the whole thing. It increases the pressure to reduce side effects, inconvenience, cost, fear and any other barrier to getting kids vaccinated. Generally, the whole thing works better.
The fundamentalist is not serving principles more faithfully than the centrist or pragmatist. She's often just being argumentative and trying to be right to the detriment of her principles.
Declaring all state involvement or authority to be (equally?) coercive and violent is silly, thinking in discreet categories when the world of human beings is fuzzy. Ignoring people's agency in the decision to vaccinate them or their children is an obvious violation is a basic morally deafness.
I see comments like these from smart people who think more deeply about such things than the average person. It's baffling. Almost makes me think that the whole enterprise of moral philosophy and political philosophy is counter-productive. People fall into traps of vainly searching for consistency and leave their moral sense behind, with common sense far behind.
TLDR: There is no reason to forgo obesity for vaccination or vaccination for freedom. People are motivated into these arguments by a desire to be right, not to help people be free or healthy.
Personally, the law California passed seems a reasonable compromise to me. Once it's phased in, it makes it possible for parents to still opt-out their children but it 1.) makes it very much a non-casual decision, given that they'll probably have to home-school as a result, and 2.) keeps the children away from at least one of the locations (school) where they would interact with the largest population of other children.
Yeah, but no significant group is arguing for that; its a strawman.
> Personally, the law California passed seems a reasonable compromise to me.
Its not really much of a compromise -- its pretty much the far extreme of what mandatory vaccination proponents actually seek.
Vaccination proponents seek vaccine-preventable diseases to be largely prevented.
What do you mean by "mandatory vaccination proponents" if not the previous sentence you just dismissed as a straw man. Why are you trying so hard to be combative?
People actually supporting the idea that government should mandate vaccination of children in some circumstances; the real people on the other side of the actual government policy debate from anti-vaxxers.
Which, in fact, proposed laws--including the one passed in California--do not do. Yes. There are significant consequences to not vaccinating children (where there is no medical necessity) but it's not mandatory under any circumstances.
By and large, vaccination proponents recognize that the key is to hit certain vaccination percentages for herd immunity reasons. At least in some areas of the country (e.g. Marin County), allowing personal belief opt-outs without consequence do not achieve those percentages. The assumption is that requiring vaccination to attend public schools (absent medical reasons to opt-out) will reduce the number of children who do not get vaccinated.
Not yet. If you don't think propaganda will align "drug-de-jour" with vaccination, you can go back half a century in the history books and find some surprising artwork. The point is that it's a bad precedent to coerce. The whole idea of the federal hammer (all-or-nothing) has betrayed the notions of community and local governance. I see the discussions on Nextdoor.com for my neighborhood, but it's ultimately left up to the Feds to mandate. Why aren't the states doing this? Because they are too afraid of the backlash, while the aloof congresspeople are obviously detached.
In general, I would argue that a state has the authority to compel someone into doing anything that has been sufficiently demonstrated to be a good decision, and so the onus is on the anti-vaxxer to show that receiving a vaccine is in fact not a good decision in their case (because it has been shown to be valuable in general.)
I'd argue that the purpose of the state is to prevent people from doing certain things. To illustrate, most of our laws are "Thou shall not..." versus "Thou must..." to punish "bad" behavior instead of compel "good" behavior.
I'm wondering what basis you have for drawing the line there.
Personal autonomy. Your body, your choice.
Or why a simple waiver process wouldn't be sufficient to handle those who object.
Because a waiver process implies that it's the government's choice and not the individual's.
In general, I would argue that a state has the authority to compel someone into doing anything that has been sufficiently demonstrated to be a good decision
Can the state compel everyone to be a vegan unless they can show proof of a medical condition that would make it unworkable?
They work by having the vast majority of people not carriers so that the few that don't end up protected directly are still protected.
This is sorta like having shitty brakes and tires. Sure you're the person most likely affected but there's a good chance your accident is going to mean harming someone that does have good brakes and tires.
Except that it's not your body.
If you don't get vaccinated, and you get sick, then you infect everyone else. You don't have the right to choose to infect other people.
Vaccination needs to be mandatory, and if the state has to send agents to burst into people's homes, tie people down, and forcibly administer the vaccinations, then I'm all for it.
> If you don't get vaccinated, and you get sick, then you infect everyone else. You don't have the right to choose to infect other people.
I would NOT be against public schools mandating vaccines in order for children to attend school. Same for places of employment.
I appreciate your concern, but this is a slippery slope fallacy. It's highly unlikely it would be abused without knowledge, because we currently have a net-good policy that is being "debated" at all levels today. I can't imagine a net-neutral or net-evil policy would slip by undetected.
More generally: Slippery Slope is a logical fallacy. It, along with many of it's brothers [1], do nothing to prove a point in a logical debate. They do no represent MUSTs, they represent SHOULD, MAY, and OPTIONAL [2]. These are rhetorical devices that you should use when you are feeling out the scope of the problem and advocating for policy in a political debate. And it can be relevant to call them by name, but dismissing an argument because you can name it is actually illogical.
[1] https://en.wikipedia.org/wiki/List_of_fallacies#Informal_fal... [2] https://www.ietf.org/rfc/rfc2119.txt
Of course it is. Do you feel the pain when I get stuck by a needle?
If you don't get vaccinated, and you get sick, then you infect everyone else.
This is a possibility. Life is risk.
You don't have the right to choose to infect other people.
That is true. They also have the right to decide for themselves if they want to be vaccinated. As I said, I was vaccinated and I had my children vaccinated. I hope that everyone does. I am opposed to using the coercive force of government to make them do it.
Vaccination needs to be mandatory, and if the state has to send agents to burst into people's homes, tie people down, and forcibly administer the vaccinations, then I'm all for it.
Should the state be willing to kill people in order to administer vaccines to keep them from getting sick and dying?
"Personal autonomy. Your body, your choice."
That's a nice slogan, but it isn't actually realized anywhere. It's always your choice when there's a clear advantage -- that is, when the state doesn't "know best" about your body. And it absolutely reserves the right control your body for the greater good.
"Can the state compel everyone to be a vegan unless they can show proof of a medical condition that would make it unworkable?"
They can if there is good evidence to show a vegan diet is strictly superior to all others.
So for a more appropriate example, it can compel you to use a seatbelt in an automobile, because there are real social costs to not doing so. It doesn't matter if you want to take a risk, once you go to the hospital, you are utilizing a public resource. And the state has a responsibility to ensure those resources are available and used efficiently, which means preventing unnecessary emergencies. (Like what would occur if you contracted something like polio.)
Can the state be sued for failing to fulfill that responsibility?
The state may well have an interest in doing that but it does not have that responsibility.
But really, you might sue them, but that's not the only way to fix that kind of problem. You could also elect a new government, or create laws or regulations to prevent mismanagement, or usurp the government. Suing is only one way to interact with a government that makes mistakes, and it's certainly not a necessary mechanism for doing so.
That's true legally, and in theory, but if someone tries to medicate me without my permission I'll leave the country. I can't trust the government with my health given its track record on drugs, the tuskegee experiment, the whole nasty eugenics business, the miserable mess that is psychiatric drugs, and doctor assisted suicide laws, and visitation/commitment rights. It's extremely clear the government does not have my health in its sights but is rather driven by a paternalistic morality supporting existing social and industrial entities. Even paternalistic forces must earn respect before the subordinate cooperates.
NOTE: I was on Risperdal (risperidone) for two years. It made me lactate painfully (I'm male) and I couldn't work well. My thoughts were scattered. I never should have been prescribed it; the positive effects of the drugs I was taking was mostly from the SSRI stabilizing my emotions. Even that is hard to justify given the subtle nature of the perceptual change, its low effect on my actual depression, and the large physical side effects.
And it's not so much that there was a mandate to prescribe risperidone, more that they prescribed me a very, very shitty medication when I was a ward of the state. It's their responsibility to ensure the doctors and RNs have accurate, up to date knowledge of the medication they're educated to prescribe by the FDA. IMHO they failed with risperidone.
Well, they can apparently compel everyone to give up eating horsemeat. If banning beef was politically viable, perhaps they could do that too.
For example, I could make my own wine and beer at home, for my own personal use but I can't sell it without accepting government oversight.
How many people would fly on a regular basis if the state outlawed commercial manufacture of airplanes?
If not being a vegan had a negative effect on the health and safety of the people around you, then yes, they could and should do exactly that.
Vaccination is a good example. As an individual there is a really small risk in not vaccination if everybody else do otherwise (the disease can't spread). If there is no regulation then the Nash equilibrium will be at a not desirable point, where a certain percentage of people still don't vaccinate and the disease never dies out. If there is a regulation it can increase the cost of not vaccinating (most easily you pay a high amount of fine and you still have to vaccinate) and shifts the Nash equilibrium to a more effective point.
tl;dr: you don't vaccinate only for yourself and your kids, you vaccinate for everybody stopping the spreading of the disease.
[1] https://en.wikipedia.org/wiki/Tragedy_of_the_commons
edit: Note that making vaccination mandatory is not the only (but IMHO an effective) way to motivate vaccination. The state can reward people who take vaccination.
Such as put other people in danger?
Consider that the state does compel you not to kill humans. If non-humans were accorded similar rights (which is a separate discussion) then yes, they most certainly could.
EDIT: wording
The state regulates the killing of humans. If you forcibly enter my home with a perceived intent to harm me or my family and without any right to do so, I will kill you and never run afoul of my state's laws.
If you attack me and I find myself in fear of death or grave injury, I will kill you and never run afoul of my state's laws.
Okay, the state now orders all the people to stop eating red meat and show up for 45 minutes of mandatory PE at 6 am monday, wednesday and friday.
After all the list of benefits of exercise is tremendous.
These are dangerous words. "Sufficiently demonstrated to be a good decision"? What does that even mean? My take on trying to derive the meaning of that sentence is that it doesn't actually mean anything.
What is a "good decision" and what does it mean to be "sufficiently demonstrated"? I posit that no one could sufficiently define those words as to make an actionable decision criteria that satisfies those (highly abstract) requirements.
Many states have felt that it was a good decision to force people into labor or death and the consequences have been severe. Are you really trying to reuse their (poor) reasoning?
Taking your argument to the logical extreme, your argument implies that the state has the authority to impregnate women.
Not arguing against vaccines, (I'm pro vaccines), but I'm against giving this much power to the government. Government abuse of power is always a question of "when and how", never a question of "if".
However, the very nature of state as we know it is to have the power of compulsion over many things. It's a spectrum.
I've heard both sides of the vaccine argument and they both have points.
Would you expand on this?
2. The Government has proven that it can be tricked (Volkswagen) and influenced by big money so its easy to not trusts the Governments medical recomendations, and reports.
3. Since 1986 vax manufactuers can not be sued for hurting your kid because of the NCVIA. Since 1986 the amount of vaccines that have been added to the schedule has increased. Anybody over 30 did not have as many or the same vaccines that are recommend for children now.
Pro-vax 1. Vaccines have eradicated issues that were deadly in the past
2. Vax works best if we all do it.
3. Yeah vax may hurt you but a seat belt could hurt you too. Still the majority of the time it is safer to where the seat belt.
4. I had vax and I'm fine so my kids can have vax.
5. Yeah the vax can cause problems but so can the diseases they prevent.
[0] http://www.goodreads.com/quotes/65213-briefly-stated-the-gel...
Yes; they do not have a point as regards vaccines.
Because vaccines are so essential to public health, they're very closely regulated and monitored by the FDA. Samples from each and every lot of each and every vaccine are passed to CBER and tested (for efficacy, sterility, etc) at several stages of production, and licenses for distribution are granted per lot, based on passing those tests.
The FDA knows exactly what they want from these drugs, what the active agents are and how they work, and how to test for them. They don't accept cleverness or variations. There's essentially no profit in this process and no room for profit.
Vaxx yourself, force your wife and child to vaxx, create a policy of only befriending vaxxed people, but the next time you think about telling me what to do, you can fuck off.