Let the Liar Beware

A significant proportion of our population is scientifically illiterate.  They have no understanding of the Big Bang Theory or Darwin’s Theory of Evolution.  Actually, one quarter are functionally illiterate and only one third can perform simple arithmetic calculations.  Yet, they manage to function in life quite reasonably.  They are oblivious to scientific misinformation and disinformation.

The consequences change dramatically when we consider medical misinformation and disinformation.  This causes people to behave in ways that endanger their health and possibly their lives.  For example, they undergo procedures or take drugs with no proven benefits, and often dangerous side effects.  Or, they buy supplementary insurance that will never pay any claims.

The courts assert “let the buyer beware.”  The TV ads for prescription drugs appear to cure your maladies, but there is no requirement that they are truthful.  The 1st Amendment protects the pharmaceutical companies from legal action.  The Supreme Court fully backs the right to lie.  You can say anything you want.  It is the responsibility of the buyer to validate advertisers’ claims.

How can the public do this?  If 6% of people taking a drug experience a 3% improvement in their health, how could one know this and determine how these percentages apply to them?  People expect their physicians will understand such evidence.  Physicians learn about it from pharmaceutical companies’ marketing representatives.  The classic example of this practice was Oxycontin. 

It might be reasonable to expect that the Federal and Drug Administration will have validated any evidence provided by the pharmaceutical companies.  John Abramson’s recent book, Sickening: How Big Pharma Broke American Health Care and How We Can Repair It (Princeton University Press, 2022), explains how the pharmaceutical companies have avoided this and contributed to the US being 1st in healthcare spending and 68th in healthcare outcomes.  We are spending enormous amounts on things that do not work.

How can we really know?  First of all, the evidence of the efficacy of a healthcare intervention should not be provided by those trying to sell you the intervention.  Second, there need to be standards of evidence and social media rarely, if ever, meet such standards.  Third, the purveyors of misinformation and disinformation need to be liable for the consequences of people believing them.

Consequently, the 1st Amendment should be modified to say, in effect, “You can say anything you want, but you are responsible for the behaviors and outcomes that your assertions motivate.”  Lying is still legal, but the consequences of lying are punishable.  Let the liar beware.

The Sandy Hook Elementary School shooting occurred in 2012.  The lawsuits for Alex Jones tirade of disinformation about this tragedy are still being adjudicated ten years later.  We need legal practices that more quickly provide consequences for such egregious behaviors.  Such practices, if well enforced,  should moderate the occurrences of egregious behaviors.

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