Viagra Creep

Health and medicine explained.
May 15 1998 3:30 AM

Viagra Creep

Quality-of-life drugs may threaten more than insurers.

(Continued from Page 1)

The transformation of normal to abnormal may start with a pill. But the physician's need for diagnosis is what drives the process. Since the new quality-of-life drugs can have adverse health effects, the drugs need to come through physicians. But we don't give out drugs willy-nilly. We must provide a medical reason--a diagnosis. So we call impotence "erectile dysfunction," baldness "hypotrichosis," and so on. The rapid increase in attention-deficit disorder is a striking example of diagnosis creep. The disorder hardly seemed to exist before the stimulant Ritalin came along. A core group of kids do have a distinct attention abnormality, but Ritalin worked so well--it can reduce distractibility even in perfectly normal children--that now almost any "difficult" child is considered for the diagnosis and drug. A 1990 study found that 28 percent of children diagnosed with the disorder didn't actually meet the definition. Nevertheless, the percentage of children on Ritalin has doubled since then.

Advertisement

By giving a patient's condition a medical name, we turn it into a medical abnormality. That creates a presumption that insurers must pay. It also creates a presumption that it will be treated. If I write a new diagnosis in a patient's chart, I have to indicate what I plan to do about it. It'd be malpractice not to. More than that, once a condition is established as a diagnosis, society practically treats it as a crime not to do something about it.

This raises an ironic prospect. Quality-of-life drugs offer not just the pleasing possibility that you can do something about impotence, baldness, blackened toenails. They create a culture in which you must fight against these conditions--even if it means risking serious side effects (the anti-fungal drugs for nails can damage the liver, Propecia's anti-testosterone action can decrease libido). By their sheer effectiveness, the quality-of-life drugs narrow the range of what society accepts as normal. In doing so, they may ultimately reduce the quality of life for the many of us who are less than perfectly endowed.

If you missed the sidebar on how Viagra works, click.

TODAY IN SLATE

War Stories

The Right Target

Why Obama’s airstrikes against ISIS may be more effective than people expect.

The One National Holiday Republicans Hope You Forget

It’s Legal for Obama to Bomb Syria Because He Says It Is

I Stand With Emma Watson on Women’s Rights

Even though I know I’m going to get flak for it.

Should You Recline Your Seat? Two Economists Weigh In.

Doublex

It Is Very, Very Stupid to Compare Hope Solo to Ray Rice

Or, why it is very, very stupid to compare Hope Solo to Ray Rice.

Building a Better Workplace

In Defense of HR

Startups and small businesses shouldn’t skip over a human resources department.

Why Is This Mother in Prison for Helping Her Daughter Get an Abortion?

Politico Wonders Why Gabby Giffords Is So “Ruthless” on Gun Control

Behold
Sept. 23 2014 4:45 PM An Up-Close Look at the U.S.–Mexico Border
  News & Politics
Foreigners
Sept. 23 2014 6:40 PM Coalition of the Presentable Don’t believe the official version. Meet America’s real allies in the fight against ISIS.
  Business
Moneybox
Sept. 23 2014 2:08 PM Home Depot’s Former Lead Security Engineer Had a Legacy of Sabotage
  Life
Outward
Sept. 23 2014 1:57 PM Would a Second Sarkozy Presidency End Marriage Equality in France?
  Double X
The XX Factor
Sept. 23 2014 2:32 PM Politico Asks: Why Is Gabby Giffords So “Ruthless” on Gun Control?
  Slate Plus
Political Gabfest
Sept. 23 2014 3:04 PM Chicago Gabfest How to get your tickets before anyone else.
  Arts
Brow Beat
Sept. 23 2014 8:38 PM “No One in This World” Is One of Kutiman’s Best, Most Impressive Songs
  Technology
Future Tense
Sept. 23 2014 5:36 PM This Climate Change Poem Moved World Leaders to Tears Today
  Health & Science
Science
Sept. 23 2014 4:33 PM Who Deserves Those 4 Inches of Airplane Seat Space? An investigation into the economics of reclining.
  Sports
Sports Nut
Sept. 23 2014 7:27 PM You’re Fired, Roger Goodell If the commissioner gets the ax, the NFL would still need a better justice system. What would that look like?