Preparing Legislation with the same care as Drugs?
Legislation should be prepared and implemented with care. This is known as “legislation quality” and although given lip service in many countries, including NZ, it is more honoured in the breach! For example Attorney General reports noting that legislation breaches basic human rights, but it is passed anyway, under urgency. Fools rush in, where angels fear to tread.
It is difficult to communicate why this is so, as most people expect legislation to work fully with desirable effects and have no adverse outcomes at all. Especially in the social sphere, it isn’t that simple. Maybe an analogy with introducing new drugs will illustrate these types of issues?
Drugs are meant to be tested for efficacy before being introduced. Then they are meant to be carefully monitored for adverse outcomes.
Similarly, the efficacy of new legislation needs to be checked before passing into law. After passing into law, it also needs to be monitored for adverse outcomes, with the same care as drugs. If this is not done, then problems that could have been stopped while they are small, progress on to be unnecessarily huge problems. Again, this concept is called “legislation quality”.
In the same way that this concept may be taken from medicine to law, disastrous examples can also be taken from medicine to law.
This example has been chosen from several such examples, in that the casualness of “it seemed like a good idea at the time” of the idea to prescribe DES matches the cavalier approach to putting together the DV Act.
Uploaded on Oct 18, 2011
Dr. Robert Hoover, director of NCI’s Epidemiology and Biostatistics Program, discusses a new study of diethylstilbestrol (DES), a drug once prescribed to pregnant women. Dr. Hoover describes the history behind DES and the long-term health effects that are now known to be associated with prenatal exposure to the drug. A written article about the study appears in the NCI Cancer Bulletin: http://www.cancer.gov/ncicancerbullet…
Summary of Failures to Test and Monitor Drug Use:
1. A whole generation of medical students now don’t know about DES.
2. [1.00] DES was the first synthetic estrogen ever synthesized, in 1938.
3. [1.12] Shortly after in 1940s, it was prescribed to pregnant women [in an attempt] to prevent miscarriages.
4. [1.19] In the 1950s 4 clinical trials were carried out to test the efficacy of DES for reducing miscarriage [and also to see if there were obvious adverse effects].It was found to not have any positive effect of reducing miscarriages.
5. [1.37] In the 1960s a number of rare vaginal cancers were found, in a group of young women and adolescents. These cancers had previously only been seen in very old women. Alert clinicians noticed this and started to investigate the causes. One of the women’s mother asked the clinician if the drugs she had taken during pregnancy might have been the cause, in particular DES?
6. [3.40] This situation clearly shows the value of clinical trials and paying attention to them.
7. [3.50] The value of NOT treating someone with a drug, for which it hasn’t been shown to be any good.
8 [3.55] This is also a demonstration of the particular vulnerability of the fetus and of very early life exposures.
9. [4.25] For a clinician, this points to the need for post marketing surveillance of drugs.
10. [5.15] The only reason we know about the effects of DES, was that the first one was a very unusual tumour occurring in an unusual group [ie young women].
The DV Act 1996 Story (transmuted from the DES Story).
The following paragraphs are listed in date order. Thus in a few case, the links to the DES story are out of order. When you look closely at these order changes, it only shows up how incompetent and unethical the whole DV Act process has been.
4. In the 1980s 6 police arrest trials were carried out to test the efficacy of automatic procedures for reducing DV. Although this opened up the opportunity to look for adverse effects, no data was gathered in this area.. Automatic procedures were found to have only a small positive effect of reducing DV. The successive trials (ie replications) showed quite widely varying outcomes, which is a concrete indicator that a reliable, robust process has not been developed. This would normally be taken as a warning that implementation should not proceed immediately, but that further research should be carried out to obtain better understanding of what works well and what does not. The sense of urgency and political expediency trumped caution and wisdom.
1. A whole generation of legal workers now don’t know about the defective process leading to Parliament passing the DV Act in 1996.
2.1996 Although research on the impacts of compulsory arrest or automatic type procedures was available from the USA, this was ignored in the rush to attempt to save about 12 women’s lives per year and about 8 children’s lives. (This also ignored that homicides by mothers resulted in many more deaths of children each year (typically over 25), but the focus was put onto homicides carried out by men.)
3. DV Act was the first time that “women’s interest’s” had been prioritised over .men’s right to natural justice. The impact of this fundamental change back to medieval type legal processes was never thought through, before this treatment was pushed onto the whole population of young men. Although the mantra was “women’s interests”, women and children haven’t really gained at all. The only party to have taken benefit from the DV Act, has been legal workers. Given that they were the originators and champions of this legislation, there is a clear breach of conflict of interest.
Notice that in the DV example, these USA police arrest trials were carried out well prior to Parliament passing the DV Act. Thus there is no excuse at all, for passing substandard legislation which fails to take into account the lessons learned in the trials. The fact that the trials did partly bring out the problems, leaves the people who took part in Parliament passing the DV Act with complete responsibility for the outcomes, both the lack of positive effects and also for the social costs of the adverse outcomes.
5. Through the late 1990s and early 2000s, comments were made by counsellors who treat men, that men were discussing suicidal ideation related to separation and being denied access to their children. Other commentators had expressed concern that they knew of small numbers of actual suicides, related to men being denied contact with their children. Juliette Gilbert suicided in a hotel room in Oregon 29th June 2007, after having been denied all contact with her only son for 18 months. She had earlier abducted her son to NZ and after return to USA, the father denied her all contact with Sky. This well publicised example concretely showed that parents are particularly vulnerable to suicide triggered by denied access.
Despite these comments, there was no investigation of the successive upturns in young men’s suicide rates, through the late 1970s to 2008. Suicide research based in hospitals focussed on women’s attempted suicide and on ethnic group’s suicide rates. Young middle aged men’s completed suicides, although largely visible in published statistics, just did not show up on hospital based researchers radar. This was possibly because men’s completed suicides were outside of their personal experience within the hospitals.
6. This situation clearly shows the value of clinical trials and paying attention to them.
In the 2008 the Justice Department called for submissions regarding the DV Act. They specifically asked to not be supplied with first principles analysis of the efficacy of the DV Act. Although I wanted to prepare such an analysis, I considered I did not have the resources or knowledge to perform such an analysis. However, their call for such spurred me to attempt this analysis. The submission was made in 2008, but was ignored in every aspect.
The submission is available under the following link: DV Act Submission 2008
7. The value of NOT treating someone with a drug, for which it hasn’t been shown to be any good.
The DV Act has been shown by earlier police arrest studies research and later by experience in NZ to not save women’s or children’s lives from DV, by formal analysis in 2008 and by informal comments since 2000.
8 This is also a demonstration of the particular vulnerability of the fetus and of very early life exposures.
See comments above at #5 where the vulnerability of parents to suiciding after denial of contact with their children is shown.
9. For a clinician, this points to the need for post marketing surveillance of drugs.
With respect to the DV Act, the concept of legislation quality suggests that where the efficacy of legislation is not known, it should be monitored in the same way that drugs are meant to be monitored for efficacy and adverse outcomes. To fail to monitor competently, is to allow adverse outcomes to keep occurring to a number of people that keeps on increasing. This can easily cost large numbers of lives and damaged lives.
10. The only reason we know about the effects of DES, was that the first one was a very unusual tumour occurring in an unusual group [ie young women].
In the case of the DV Act, the adverse outcomes are in the form of a fairly rare outcome, suicide. However, due to the protective secrecy around the familycaught$, even parents and siblings of the suicided parent usually do not have access to information that may have triggered the suicide.
In any case, they are usually paralyzed by grief, so that they are not in a position to do the safety analysis, that is really the Government’s responsibility.
Where there is life, there is hope.
There would be no pleasure in saying this to family of a suicided parent?
It is also worth remembering that a parent’s suicide, significantly increases the suicide risk of the offspring. The suffering does go on, long after the suicide.
When legal workers think they can do risk analysis, social research or even propose legal treatments, usually they are not competent in what is actually a quite different field to legal practice. With all due respect, they are amateurs when working way outside their field of expertise. To attempt to do such work is unethical, as well as incompetent and unprofessional. When they do this, even their basic legal competence needs close checking.
Incidentally, the history of the DES story shows that doctors have put much more effort into impacts on daughters, than impacts onto sons, but that is a different story.
MurrayBacon – frustrated axe murderer.