Charles Krauthammer

WASHINGTON -- Amazingly, the congressional hearings on Toyota were relatively civilized. Apart from some inevitable theatrical hectoring, the questioning was generally respectful, the emotions controlled. This was all the more remarkable given the drama of some of the testimony, such as that offered by a tearful Rhonda Smith, who recounted how, in her runaway Lexus, she had called her husband because "I wanted to hear his voice one more time."

Such wrenching and compelling stories might impel you to want to string up the first Toyota executive you find. But the issue here is larger and highly complex.

Industrial society produces an astonishing array of mass-produced products -- cars, drugs, medical devices -- that are at once wondrous and potentially lethal.

The wondrousness sometimes eludes us. Even the lowliest wage earner has an automobile that conveys him with more luxury, more freedom, more comfort than any traveling king ever experienced in all the centuries before the 20th. And modern medicines -- why, vaccines alone -- have prevented more suffering, more debility and more death than anything ever conceived by man.

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But these wonders can be lethal. And sorting out the endless complaints about these products is maddeningly difficult -- though sort you must, otherwise every complaint would require shutting down the factories, and we'd have no industrial society at all.

The question is: How do you distinguish the idiosyncratic failure from the systemic -- for example, the single lemon that came off the auto assembly line versus an intrinsic problem inherent in that model's engineering? How do you separate one patient's physiology producing a drug side effect versus an intrinsic problem with a drug that makes it unacceptably dangerous?

Consider the oddity of those drug commercials on television. Fifteen seconds of the purported therapeutic effort, followed by about 45 seconds of a rapidly muttered list of horrific possible side effects. When the ad is over, I can't remember a thing about what the pill is supposed to do, except perhaps cause nausea, liver damage, projectile vomiting, a nasty rash, a four-hour erection and sudden death. Sudden death is my favorite because there is something comical about it being a side effect. What exactly is the main effect in that case? Relief from abdominal bloating?

And how many sudden deaths does it take until we say: "Enough," and pull the drug off the market?


Charles Krauthammer

Charles Krauthammer is a 1987 Pulitzer Prize winner, 1984 National Magazine Award winner, and a columnist for The Washington Post since 1985.

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