The greatest good?

Published: Mon, 03/29/21

In the late 1950s a drug came on the market called Thalidomide. Originally developed by the German pharmaceutical company Chemie Grünenthal GmbH this drug was found to be effective for treating colds, flu, and various forms of nausea, including morning sickness in pregnant women. In 1958 Thalidomide was licenced in the UK and produced by The Distillers Company under several brand names. Distillers saw a gap in the market and advertised their new product as:

‘Distaval can be given with complete safety to pregnant women and nursing mothers without adverse effect on mother or child.’

However, it was later determined that if a pregnant woman took this particular drug between 20 and 37 days after conception there could be devastating consequences for the developing fetus. It is estimated that about 10,000 babies were affected. Half did not survive the pregnancy. The other half were born with various disabilities which often included missing, or seriously malformed, limbs. The drug was formally withdrawn from use at the end of 1961. Both my brother and I were conceived and born during that period of time. I don’t know if my mother ever took medication to cope with morning sickness, I suspect that she did not because she had a pretty stoical attitude to life. Also, 37 days is quite early in a pregnancy and many women do not even realise that they are pregnant at that stage which may explain why many more people were not affected by this catastrophe.

There are moments in history that I think of as Titanic occasions. The Titanic was the ship that could not sink and didn’t need very many lifeboats or lifeboat drills, and may not have done until it hit that iceberg. Thalidomide created a similar moment for the pharmaceutical industry and subsequently requirements for testing and prescribing drugs were radically reviewed and tightened up. The UK’s 1968 Medicines Act was passed as a direct result of the Thalidomide Scandal. The yellow card scheme was introduced too enabling doctors, and later patients, to report side effects of prescription medications.

Thalidomide was never licensed in the USA because the Food and Drug Administration under the influence of the reviewer, the Pharmacologist Frances Oldham Kelsey, turned down several requests from the companies keen to distribute the drug as she was not convinced of its safety. Considering how much the Americans love their pharmaceuticals Kelsey probably saved the lives or well being of hundreds of thousands of US citizens and she certainly deserves a footnote in history.

It isn’t even that Thalidomide is not an effective drug and it is still used under certain circumstances such as the treatment of leprosy. Just as the Titanic was also a very fine ship but that is not why she is remembered.

I will leave readers to draw any parallels with current events.

I find myself pondering on the difference between a utilitarian approach to life and taking personal responsibility. Utilitarianism stems from the philosophy of such 18th century thinkers as Jeremy Bentham and John Stuart Mill. The core concept is often summed up as creating situations which deliver, ‘the greatest good for the greatest number’. Which sounds fair enough and might be what you would expect from an enlightened government determined to do the best it can for the people it serves. The basic problem with utilitarianism is that the value of the individual, and their freedom to make individual choices, becomes secondary to the ‘greatest good’. The crude argument that will be used to justify utilitarian policies is that ‘the benefits outweigh the risks’, and you may have heard that phrase recently, I know I have. Lets take air travel, which is relatively safe statistically speaking. Have the benefits of international air
travel outweighed the risks of being killed in air disaster? On a mass scale perhaps. Howver if you were about to board Pan Am flight 103 on the 21st of December 1988, and you had known what was in store as the plane passed over Lockerbie in Scotland, you would not have been thinking about benefits and risks. You would simply have found an excuse for not getting on that plane. Likewise, Thalidomide may have brought very welcome relief from morning sickness to thousands of women, as well as the other theraputic uses it had. Did those benefits outweigh the risk of birth defects which became so horrifically apparent in the early 1960s?

We all die one day and we cannot see what is coming in the future. Life is a risky business that ends in death. What matters is how we live our lives before we die and that means living with courage and a willingness to take risks. The idea of Valhalla suggests that those who chose to take the greatest risks in battle would find themselves as honored guests of Odin. Death as something to be met head on, not avoided in fear and trembling. Individual choice is key. I believe that choices must be based on the realisation that because I will die one day anyway there is no point in being afraid. ‘The day of my death was foretold long ago.’ As Skirnir puts in ‘Skirnir’s Ride’.

You can’t live life without risks but that does not mean being foolish or reckless. You are going to die one day so you need to take care of the life you have, and live as well as you can by making wise decisions on what is best for you. You and I are not ‘the greatest number’, you and I are individuals who are concerned with doing the greatest good with our own lives and for those whom we love and can serve. We must make our own decisions as to what is right for us while being compassionate and caring for others. Those who would control the world may reassure us that they are doing the greatest good for the greatest number. We need to remember that there may be differing ideas of what is the greatest ‘good’ and the lesser number are not expendable. You are a sovereign being and only you know what is best for you. So, be ready to fight for your freedom to make your own decisions and be prepared to live with the consequences..

Regards
Graham


PS Interesting link to the Science Museum website with more information about Thalidomide and the consequences of its inappropriate use: https://www.sciencemuseum.org.uk/objects-and-stories/medicine/thalidomide