Would you save a thousand lives at the cost of twenty?

I saw my shrink yesterday. We were talking about weight, and obesity research. He’s a big time genetic researcher into bipolar, so I guess he knows a lot about other kinds of genetic research, as well.

As we all know, it’s hard to lose weight, but do you know how hard? He was telling me that the best treatment we have (diet and exercise) works a mere 7% of the time. That’s the best treatment. That shows you that we are going up against every defense that our bodies have—we are evolved to protect against starvation, not overeating.

Some of you may remember Fen-Phen, a diet supplement used in the 80s. It was pretty effective at helping people lose weight—a lot more effective than diet and exercise—but there were 20 (count them—20) cases where people’s arteries thickened, perhaps as a result of the Fen-Phen use (I don’t think the correlation was demonstrated, statistically).

So the FDA banned it. My shrink argues that obesity kills far more people than Fen-Phen thickens the arteries of. The risk is worth the reward. Society would be much better off. However, the FDA is so cautious, and law-suit averse, I guess, that it will not consider the benefits if there are any risks that could result in bad law suits.

If you were the FDA, would you allow Fen-Phen? How would you handle the law suits? Would you let companies be immune from them? Would an estimate of one thousand heart attacks prevented (a hypothetical number for purposes of discussion) be worth twenty cases of thickened arteries and possible deaths that might result from that?