Are Pharmacy Technicians a Danger to Your Health?

 

Today’s Headlines from Libertarian Sites

Congress
Should End The Confusion Over Medicare Private Contracting

by Robert E. Moffit (Heritage Foundation)

Watch
Your Language
by Walter Block (Mises Institute)

No
More Great Presidents
by Robert Higgs (Mises Institute)

Burning
Man Grows Up: Can the nation’s premier underground event survive
its success?
by Brian Doherty (Reason)

Conventional
Wisdom: Rediscovering the social norms that stand between law
and libertinism
by Jonathan Rauch (Reason)

Reality
Principles: An Interview with John R. Searle Eminent philosopher
John R. Searle defends free speech, free inquiry, and the Enlightenment

from Reason

The
Broken Blue Line: How to start a riot
by Jesse Walker (Reason)

Pot
Stickers: Indiana tries to punish a marijuana grower twice

by Stephen F. Hayes (Reason)

Seattle
Surprise: The WTO protests caught free-traders off guard. They
shouldn’t have
by Virginia Postrel (Reason)

Orphans
of Trade How to help all of Cuba’s children
by Nick Gillespie
(Reason)

Wiring
Washington: How to make a killing in cable
by Thomas W.
Hazlett (Reason)

Gold
Bugs Class action lawyers discover Silicon Valley
by Walter
Olson (Reason)

Faith
of Our Fathers: The Unbelief of America’s Founding Fathers

by Jim Peron (Laissez-Faire City Times)

Religious
Freedom and Private Property Rights
by Tibor R. Machan (Laissez-Faire
City Times)

Politics
in America, Part 9: A Psychotic Social Psychology, Continued

by Robert L. Kocher (Laissez-Faire City Times)

The
Power of Openness: Why Citizens, Education, Government and Business
Should Care About the Coming Revolution in Open Source Code
Software
from Laissez-Faire City Times

Karl
Popper and Friedrich Hayek: an Interview with Jeremy Shearmur

by Alberto Mingardi (Laissez-Faire City Times)

Scourge
Against the UN Moynihan’s Rebellious Daughter
by Richard
S. Ehrlich (Laissez-Faire City Times)

Columnist
Reflects New Deal View of Twisted Constitutional Views
by
Roger Pilon (CATO Institute)


   

The Associated Press recently
reported on the horror of the month — pharmacy technicians.

Pharmacy technicians are the
folks who do most of he work in modern pharmacies. Although they usually
lack any sort of formal training, they typically do the data entry for
drugs, count the actual tablets and slap the label on the pill bottle.
The pharmacist then checks everything to make sure the drug type and amount
is correct before the prescription is handed to the consumer.

According to some consumers
and regulatory bodies, this is an unacceptable state of affairs — they
want additional training required for pharmacy technicians and stiff licensing
requirements. The Associated Press gives a typical horror story. A woman
noticed the drug her 5-year old was taking contained a special warning
about giving it to children. The pharmacy technician told her this was
no problem. Unfortunately that was very bad advice, and as a result the
child suffered severe side effects including ongoing learning disabilities.

The Associated Press cites
a 1998 study by the Virginia Board of Pharmacy that found pharmacists
catching an average of 6.5 mistakes by technicians each week. Unfortunately
there are serious problems with that study. Only half of the 1,590 drugstores
surveyed bothered to respond and asking pharmacists to estimate how many
errors they spot in a given week is a very poor way of measuring the problem.

The real problem with the criticism
of pharmacy technicians, however, is that while technicians do indeed
make mistakes, the limited evidence available indicates they don’t make
mistakes any more often than regular pharmacists do. Last year, for example,
U.S. Pharmacopeia’s Medication Errors Reporting Program reported receiving
314 reports of pharmacy errors, half of which were made by technicians.
But what of the half that weren’t made by technicians? Logically, they
were almost certainly made by pharmacists.

Having spent a couple years
working as a pharmacy technician at a small pharmacy and a big chain the
basic problem in filling prescription is accurately processing data, not
having any special pharmaceutical skills or knowledge.

The main source of error is
still doctors who tend to right out almost unreadable prescriptions. It
is amazing in this day of hand-held computers, fax machines and cell phones
that doctors introduce a large risk into drug prescriptions by scrawling
out their drug orders. To really lower the risk of getting the wrong drug,
always have a doctor’s office phone in a prescription.

The second source of error
was the dizzying array of different compounds, many with similar names,
not to mention the occasional drugs that look very much alike (there are,
after all, only so many names and shapes available for the pills we take).
Such errors, in my experience, were uncommon but they did happen. However,
if a pharmacist and technician are doing their jobs, these never get out
the door. Not once did I ever see the process break down so a person go
the wrong drug.

On the other hand, such errors
are inevitable regardless of what sort of system is in place. States could
require that only licensed pharmacists have anything to do with dispensing
drugs, and such errors are still going to occur. There’s no way to get
around that.

But the presence of pharmacy
technicians probably increases the reliability of the system, since with
the pharmacy technician system the technician and the pharmacist both
check the prescription before it goes out the door. That is far superior
to having a single individual pharmacist doing the entire process from
beginning to end. To the extent that there is a problem with this system
it is that pharmacists don’t adhere to it. The Virginia Board of Pharmacy
interviewed dozens of pharmacists, with half of them saying they never
checked the results of their technicians.

Licensing of technicians or
limiting what technicians can do — both popular solutions among the regulate-it-to-death
crowd — will simply raise the cost of running a pharmacy while doing
very little to reduce the risk of a serious tragedy (largely because that
risk is probably already as low as it can get given the current economic
and time pressures).

Reference:

Proliferation
of pharmacy technicians raises questions of quality
. The Associated
Press, February 14, 2000.

The Fallacy of DNA Databases

 

Today’s Headlines from Libertarian Sites

A
Nation of Weather Weenies?
by Patrick J. Michaels (CATO
Institute)

What’s
With the Yield Curve?
by Frank Shostak (Mises Institute)

   

DNA evidence has proven extremely
useful in solving crimes. Many people convicted of crimes before the advent
of DNA evidence have been exonerated and released. But while DNA is a
very useful tool, it has its limitations and unfortunately governments
in Europe are misusing DNA — and of course law enforcement officials
in the United States want to join them.

The potential tragedy that
misuse of DNA evidence can cause was illustrated recently when police
in Great Britain admitted they misidentified a suspect based on DNA. Although
the suspect’s DNA matched DNA found at the scene of the crime, the gentleman
had an airtight alibi and after additional tests were performed the man’s
DNA was found to be slightly different. According to “experts” quoted
in numerous stories, this was a random problem that has only a 1 in 37
million chance of happening. Unfortunately that claim is nonsense — because
of the way Great Britain utilizes DNA evidence, there is about a 1 in
52 chance of such mismatches happening routinely.

DNA evidence is compelling
when comparing DNA found at the scene of a crime with that of a suspect
identified through traditional police methods. If a woman is killed and
her husband is a primary suspect, a DNA test might be useful in attempting
to exclude him as a possible suspect. The odds of any two randomly selected
individuals having a false positive is extremely low.

The problem with DNA starts
when governments start amassing huge databases. In much of Europe, DNA
samples are collected and kept on file for anyone arrested (much like
fingerprints). In Great Britain, for example, almost 700,000 DNA samples
are now included in a law enforcement database. Many law enforcement officials
in the United States want to do the same thing — take DNA from everyone
arrested and dump it into a huge database.

Then, anytime DNA is found
at a crime scene it can simply be compared to the samples in the database
and the perpetrator discovered more quickly. Except, as the British recently
found out, the result is likely to be junk. While there may be a 1 in
37 million chance of any two people in Great Britain giving the same result
on its DNA test, when you compare a DNA strand found at a crime scene
to almost the DNA of 700,000 samples, the odds of a false positive rise
to 1 in 52. That means for every 52 matches generated by such a search,
it should be expected that at least 1 is a false positive.

What happens when law enforcement
starts entering literally the DNA of literally millions of people into
its databases? Given the large number of arrests for drug and other related
offenses in the United States it is not inconceivable that within 10 years
such a DNA database would contain material taken from 20 million suspects.
At that point, the odds fall to 1 in 2 that any given match is a false
positive.

But actually the odds of a
false positive are much higher for a couple reasons. First, not all U.S.
law enforcement agencies use the same methods of quantifying DNA. When
DNA samples are analyzed laboratories usually look at up to 10 different
markers to compare samples. Using 10 markers yields the 1 in 37 million
odds of any two samples being identical. But many state agencies currently
collecting DNA evidence use only 6 or 8 markers (the more markers, the
higher the cost of the test). So existing DNA evidence is even more prone
to false positives.

Second, the 1 in 37 million
figure assumes that there is an equal distribution of DNA characteristics
throughout the population. This may be true when comparing samples of
two random individuals, but certainly will not be true of any DNA database
created in the United States. Some DNA characteristics vary by race, obviously,
and since a much larger percentage of minorities would be included in
a U.S. DNA database than non-minorities (compared to their distribution
in the normal population), the result would be that the distribution of
DNA characteristics in the resulting database would be far from even.
The only way around this would be to include the DNA of every person in
the general population which, unfortunately, would be self-defeating since
it would raise the odds of a false positive rise dramatically; assuming
a U.S. population of 260 million, running a random DNA sample against
such a database would on average yield more than 7 false positives for
every genuine match.

Now in Great Britain this may
not be much of a problem. British authorities have already done away with
their version of the Fifth Amendment — judges and juries can now consider
a suspect’s unwillingness to testify as evidence of his or her guilt.
There is also talk by the ruling Labor Party of doing away with trial
by jury for a whole host of crimes such as burglary (jury trials are said
to be too expensive). But the United States was founded on the view that
protecting the rights of the individual against the state is of paramount
importance. The People insisted that the right against self-incrimation
and the right to a trial by jury were preserved in the Bill of Rights
specifically to avoid the potential shenanigans that now dominate British
jurisprudence.

The recent false accusation
caused by a British DNA database is one more reasons to be skeptical of
poorly thought out European imports to the American legal system.

Should Despicable People Be Lawyers?

 

Today’s Headlines from Libertarian Sites

Do
GOP Voters Have a Choice When It Comes to Taxes?
by Doug
Bandow (CATO Institute)

The
Ecological Capitalist: an Interview with Lou Licht
by Don
Lobo Tiggre (Laissez-Faire City Times)

The
Hockey Business
by Peter Topolewski (Laissez-Faire City
Times)

Atlas
Slugged: Why Many Intellectuals Hate Ayn Rand
by Jim Peron
(Laissez-Faire City Times)

The
Anti-Austrian Hypocrisy
by Tibor R. Machan (Laissez-Faire
City Times)

Sex
Is the Answer!
by Sunni Maravillosa (Laissez-Faire City
Times)

Point
and Cast
by Jeff A. Taylor (Reason)

Easy
Money: Bank customers rebel at the price of convenience

by Thomas W. Hazlett (Reason)

Japan’s
Attack on Microsoft
by Shigeki Kusunoki (Mises Institute)

The
President’s Budget Proposes A High-Tech Pork Barrel
by Adam
D. Thierer And Gregg Vanhelmond (Heritage Foundation)

“Pure
and Perfect” Competition? By What Standard?, Pt.5
by Richard
M. Salsman (Capitalism Magazine)

   

Matthew Hale is not the sort
of person most people would want to invite over for dinner. A White Supremacist
and leader of the World Church of the Creator, Hale’s views about race
are despicable. But should his views on race be enough for the Illinois
to bar Hale from practicing law in that state?

Hale graduated from law school
at Southern Illinois University in 1998 and has passed the bar exam, but
the state refuses to grant him a law license saying his racist views make
it impossible for him to meet the criteria necessary to be a lawyer. As
the Associated Press sums up Illinois’ case against Hale:

[The Illinois State] Committee [on Character and Fitness] members
said his views would prevent him from fulfilling a lawyer’s duty not to
discriminate against litigants, jurors, witnesses or others for reasons
of race, religion or national origin.

The obvious solution would
be to monitor Hale and punish him if he should actually discriminate based
on race, religion or national origin rather than judging him guilty of
such offenses based entirely on his views on race.

But do we really want lawyers
who do not discriminate or hold prejudicial views? There was a case a
couple years ago about a lawsuit against a female divorce attorney. The
attorney specialized in representing women in divorce cases and generally
turned down men who asked her to represent them. On man turned down this
way sued her for sexual discrimination.

In fact a wide variety of prominent
lawyers hold prejudicial views that, using this sort of standard, would
have to be disbarred. Is a defense lawyer who insists that cops regularly
commit perjury likely to be able to treat potential police clients fairly?
Can an atheist lawyer truly be fair minded about potentially religious
believing clients (and conversely can a Southern Baptist lawyer really
take into account the rights of atheist clients?)

Clearly what should count in
such matters is not beliefs but actions. If Hale is guilty of racial discrimination
then Illinois should be free to disbar him, but punishing him based entirely
on his beliefs sets a dangerous, intolerable precedent.

Reference:
White supremacist appeals law license refusal to U.S. Supreme Court

from the Associated Press

The Americans With Disabilities Act and the Web

 

Today’s Headlines from Libertarian Sites

Balancing
Family and Freedom
by Doug Bandow (CATO Institute)

Ecuador’s
Problems Not Just ‘Bum Luck’: Ecuador’s financial sector has
been bankrupted by corruption and inflation
by Stephen Johnson
(Heritage Foundation)

Time
To Act On Taiwan’s Security
by Stephen J. Yates (Heritage
Foundation)

Congress,
Not The President, Has The Better Plan To Facilitate Public
School Construction
by Ronald D. Utt (Heritage Foundation)

   

There is currently a movement
afoot to apply the Americans with Disabilities Act to the World Wide Web.
Lawyers recently sued America Online, for example, arguing that its heavy
reliance on a graphical user interface made it difficult for blind users
to access the service. According to Walter Olson, who runs Overlawyered.Com
and has published extensively on legal issues, the Justice Department
has already indicated that much of the activity on the Internet likely
falls under the ADA.

What the lawyers and activists
want might not sound that difficult or imposing to those not involved
in creating web content, but it could pose serious problems. According
to the W3 Consortium, content is considered inaccessible if it includes
“images without alternative text; lack of alternative text for imagemap
hot-spots; misleading use of structural elements on pages; uncaptioned
audio or undescribed video; lack of alternative information for users
who cannot access frames or scripts; tables that are difficult to decipher
when linearized; or sites with poor color contrast.”

Olson was kind enough to post
his testimony
to a House subcommittee
on the dangers this sort of standard poses
to the explosion of web sites that has occurred in the past few years
which outlines many of the problems. In fact if applied strictly, the
ADA would make sites like this one impossible.

I currently run 8 or 9 web
sites and pretty much do all the writing, editing, HTML-work, graphics,
etc. The amazing thing about the web is that extremely small groups of
people can quickly and efficiently publish information and commentary
and compete with larger publishers in ways that were impossible before
the Web. The main reason is the low cost. This year I will reach between
5 and 6 million readers while spending less than $2,000.

The problem with the ADA requirement
is that it suddenly increases the costs. I’ve got plans for a couple site
to add audio and video, and any requirement to produce transcripts would
simply destroy that possibility. Who has time to transcribe an hour long
production every week (or the money to hire someone to transcribe them)?
Large corporations and outfits with a lot more resources than I.

Olson points out that in order
to fulfill some of the accessibility requirements, people would have to
“unlearn” common HTML coding techniques, and they would probably be forced
to buy expensive new tools to do the coding as well. I know my sites are
filled with “tables that are difficult to decipher when linearized” as
a conscious part of the design.

Some of the requirements are
impossible to meet if you want a decent web site. For example, nobody
stops to ask why folks leave out alternative text for imagemap hot-spots
and graphics. The reason is not because web designers don’t want blind
readers to have access to that information, but that several versions
ago both Netscape and Microsoft made a boneheaded mistake and forced their
browsers to automatically display the alternative text as a “tool tip”.
Unfortunately, what this means is that if you have an image map with several
options, putting the cursor over the image brings up the alternative text
and often obscures or makes it difficult to see the other options. Using
alternative text on many images and image maps can make them practically
unusable.

Olson made an excellent point
on the sort of problems the ADA will cause if applied to the web when
he testified, “Amateur publishing, as by the owner of a small business
or a community group that relied on volunteers, would become more of a
legal hazard. The tendency would be for more entities to turn their web
publishing function over to paid professionals.”

I run a very successful site
on the animal rights movement
where about 250 people post regularly in a discussion forum I’ve set up.
One of the things I’ve been contemplating over the past few weeks is setting
up a program so those folks can create their own web pages on my server
relating to animal rights (kind of like a small, more focused Geocities
or Tripod). Who would the liability fall under for out of compliance web
pages on such an endeavor? Maybe me, maybe the individuals, but who wants
to risk a lawsuit just to find out?

Many years ago I worked at
a college newspaper. Some folks who thought our paper was a little too
close to the university administration decided to start their own student
group and publish an alternative newspaper. Unfortunately the student’s
began printing rather outrageous claims about individual professors and
administrators and the university brought in the lawyers. The lawyers
were afraid somebody would sue the group for libel and then try to recover
large damages from the university. Whether or not such a scenario was
likely, the university did not want to risk such litigation and demanded
the students either a) by libel insurance, which is not cheap, especially
for students or b) cease publishing as a student group. The students took
the latter route.

This is exactly the sort of
scenario which will be repeated by small web publishers in the United
States. The fear of possible lawsuits will drastically alter the behavior
of web publishers. The promise of the web was that rather than the classic
top down publishing model of a small group of people publishing to the
masses, anybody could create a web site. If the ADA and other regulations
begin to be strictly applied to the web, only people who can afford to
retain a lawyer will be able to create a web site. That would knock me
and a lot of other smaller publishers out of the game entirely.

Lack of Trust in Cops? Say It Ain’t So!

 
Today’s Headlines from Libertarian
Sites

A
Presidential Scorecard on Trade
by Aaron Lukas (CATO Institute)

Shifting
Air Traffic Control To A User-Funded Corporation
by Robert W.
Poole, Jr. (Reason)


Advancing Free Trade In Latin America: The Test Of Leadership

by Ana Eiras And Gerald P. O’Driscoll, Jr. (Heritage Foundation)


Why The Case For Tax Cuts Is Failing (And What Should Be Done About
It)
by Bruce Bartlett, Stanley Collender, and Grover Norquist
(Heritage Foundation)

Pragmatism
and Businessmen
by Andrew Lewis (Capitalism Magazine)

   

A CNN story today reported
that Los Angeles judges are beginning to worry that because of the latest
scandal involving the Los Angeles Police Department, in which police officers
may have given false testimony and evidence in thousands of cases, jurors
are beginning to doubt the testimony of police.

Larry Fidler, supervising judge
for the Los Angeles Superior Court Criminal Division, told CNN, “We
are starting to see, based on information I get from the judges I supervise,
that verdicts are being affected, not so much from the evidnece that was
presented in a particular case, but based, aparently — because there
appears to be no othe reason — on the Rampart scandal. It is also very
terrible when people who are overwhelmingly guilty walk away when the
only reason is because there is a general feeling no in the bpulic —
if that’s what its’ coming to — that police officers’ testimony can’t
be trusted.”

But why should Los Angeles
jurors believe anything an LAPD officer has to say after seeing the depths
of the ongoing scandal. Taking into account past scandals, the LAPD (and
other law enforcement agencies) seem singularly unable to rid themselves
of corruption. Until they can do so, it is not unreasonable for jurors
to subject police testimony to the same sort of scrutiny and skepticism
they give to the testimony of other witnesses.

What Fidler’s judges may be
seeing is nothing more than juror’s no longer burying their heads in the
sand and assuming everything that a police officer testifies to is the
gospel truth.

Bill Clinton’s Favorite Serial Killer

 
Today’s Headlines from Libertarian
Sites

A
Presidential Scorecard on Trade
by Aaron Lukas (CATO Institute)

Shifting
Air Traffic Control To A User-Funded Corporation
by Robert W.
Poole, Jr. (Reason)


Advancing Free Trade In Latin America: The Test Of Leadership

by Ana Eiras And Gerald P. O’Driscoll, Jr. (Heritage Foundation)


Why The Case For Tax Cuts Is Failing (And What Should Be Done About
It)
by Bruce Bartlett, Stanley Collender, and Grover Norquist
(Heritage Foundation)

Pragmatism
and Businessmen
by Andrew Lewis (Capitalism Magazine)

   

Imagine a serial killer
who managed to murder literally thousands of people over the course of
a few years. Upon his capture, our killer argues in his defense that while
he may have killed a couple thousand people at the beginning of his murderous
career, in the year before he was apprehended he only murdered a handful
of people. Our hypothetical serial killer goes on to argue that he is
clearly mending his ways and if only society would help him to get on
his feet and established he can dispense with murdering innocent people
altogether.

Certainly any reasonable person
would find such an explanation beyond absurd. Only the most depraved of
individuals would buy into this sort of twisted logic — which is exactly
why it is so appealing to the Clinton administration.

The serial killer in this case
is the Colombian army and the Clinton administration wants to reward its
murderous ways by giving Colombia $1.6 billion in “aid.” Ahead of a vote
on the aid package, Colombian President Andres Pastrana made the rounds
in Washington, DC, meeting with Clinton for 45 minutes. Pastrana beamed
about how human rights violations by the Colombian army had fallen from
about 2,000 per year to about 70 per year.

For his part Clinton, who not
that many months ago promised that the world would do everything in its
power to stop human rights violatiosn, could only manage a typically lame
“see no evil” policy. “There’s always a risk when you go out on a limb
to try to save a neighbor and help people to help themselves, that it
won’t work,” Clinton told reporters. “I believe the risk in the investment
is something that we ought to do.”

But the risks of the U.S. policy
are not to Clinton or Americans, but rather to poor Colombians. The only
reason that the Colombian Army no longer participates in massive human
rights violations is that it outsourced that job to ultra-right wing death
squads which the Army both aids and protects. The paramilitary death squads
are among the most brutal in the region.

Several days before the Clinton
met with Pastranas, for example, Leftist guerillas blew a power pylon.
Right wing death squads immediately announced that they would execute
10 leftist sympathizers for every power pylon destroyed. To back up that
threat, the paramilitaries murdered 26 peasants who they claimed were
sympathetic to the guerillas.

Of course one of the main reasons
many peasant farmers are sympathetic to the Marxist guerillas is because,
unlike the Colombian military, the guerillas tolerate and benefit from
the coca and poppy fields. The war against drugs is really one against
poor peasants, and in exchange for its $1.6 billion aid package, the Clinton
administration wants Colombia to accelerate its war against farmers growing
coca and opium poppies.

Colombia’s defense minister,
Luis Fernando Ramirez, admitted to U.S. reporters recently that a planned
push to eradicate coca crops in southern Colombia will likely ratchet
violence up another notch. “It’s predictable that there’s going to be
violence and marches,” Ramirez said as he showed off three Blackhawk helicopters
donated by the United States to help the eradication efforts.

Ironically Ramirez acknowledged
the Colombian government has a plan to permanently move farmers from the
coca regions — a tactic which the Clinton administration called a war
crime when Serbia tried it.

When critics rightly complained
that the United States had no business fighting a war against Serbia,
Clinton ridiculed his domestic opponents as isolationists who would gladly
sit around while a new Hitler (the third or fourth “new Hitler” in as
many administrations) emerged to conquer the world. But what is the point
in defending the world against the machinations of men like Hitler and
Stalin only to make it safe for paramilitary death squads in Colombia?

Americans should be outraged
at the thought of a single penny of their tax dollars going to help dislocate
and kill poor peasants in Colombia.