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Welcome to my blog, a place to explore and learn about the experience of running a psychiatric practice. I post about things that I find useful to know or think about. So, enjoy, and let me know what you think.


Wednesday, August 12, 2015

You Don't Say

There's a fascinating article in The Atlantic, The Coddling of the American Mind, that has been blogged about and tweeted by Dinah at Shrink Rap. The gist of it is that on college campuses, students and faculty who say things that are offensive are castigated and accused of microaggressions. Offensive comments include, "Where are you from?" if asked of someone Asian, and, "I believe the most qualified person should get the job.” One Harvard law professor was asked not to use the word, "violate", and others were asked not to teach rape law. Professors are supposed to issue trigger warnings for content that might be offensive or upsetting to someone.  

The article uses the phrase vindictive protectiveness to describe the phenomenon of shielding students from anything that might be upsetting. It then goes on to promote the use of CBT to prevent phobic avoidance and encourage mental health.

I'm not so hot on that last part.  To me the issue seems less about phobic avoidance than about the notion that students can only function under ideal conditions, and that everyone's ideal condition needs to be accommodated- a kind of emotional Ponzi scheme.

You can check out the article if you're interested, as well as Dinah's post, which gives a lot more detail than I do. But the reason I'm bringing it up is that it's such a stark contrast to another recent article in the NY Times, FDA's 'Off Label' Drug Policy Leads to Free-Speech Fight

The FDA currently has a policy that prevents drug Manufacturers from promoting a drug for off-label use, even if the content of the promotion is true, but this policy is being challenged under first amendment rights.


Amarin Pharma, a small drug manufacturer, challenged the F.D.A. when it sought to promote the off-label use of its cardiovascular health drug, Vascepa, for patients with a different condition. An F.D.A.-approved study showed that the use of the drug was effective, but the agency had denied approval for use by those patients.

The company and four doctors sued the F.D.A. after it threatened to bring civil charges against them if they used the study to help sell off-label use of Vascepa. They claim that the agency's rule on off-label promotion violates their First Amendment right to free speech...


Judge Paul A. Engelmayer of the Federal District Court in Manhattan found in favor of Amarin. This is tricky. It may well violate someone's freedom of speech to prevent them from stating something true, or that they believe to be true, without intent to defraud. But if a drug rep believes the conclusions of the article he enthusiastically shows to the doctor, that doesn't make those conclusions true. The FDA's policy may exist to prevent drug companies from bypassing the approval process for a new use by producing manipulated, shoddy, not to mention cheap research that they can call "true".

But think about it. On college campuses, the supposed bastions of creative ideas and innovative thought, censorship of speech is rampant. But pharmaceutical companies can say anything they want about their products, as long as they can generate the statistics to support their statements. That can't be the intention of the first amendment.






1 comment:

  1. I think the first amendment was put to rest. It was replaced by the second amendment. Sometimes I think the world is nuts. Just sayin....

    ReplyDelete