relatively civilized. Apart from some inevitable theatrical hectoring, the
questioning was generally respectful, the emotions controlled. This was all
the more remarkable given the drama of some of the testimony, such as that
offered by a tearful Rhonda Smith, who recounted how, in her runaway Lexus,
she had called her husband because "I wanted to hear his voice one more
time."
Such wrenching and compelling stories might impel you to want to
string up the first Toyota executive you find. But the issue here is larger
and highly complex.
Industrial society produces an astonishing array of mass-produced
products -- cars, drugs, medical devices -- that are at once wondrous and
potentially lethal.
The wondrousness sometimes eludes us. Even the lowliest wage earner
has an automobile that conveys him with more luxury, more freedom, more
comfort than any traveling king ever experienced in all the centuries
before the 20th. And modern medicines -- why, vaccines alone -- have
prevented more suffering, more debility and more death than anything ever
conceived by man.
But these wonders can be lethal. And sorting out the endless
complaints about these products is maddeningly difficult -- though sort you
must, otherwise every complaint would require shutting down the factories,
and we'd have no industrial society at all.
The question is: How do you distinguish the idiosyncratic failure from
the systemic -- for example, the single lemon that came off the auto
assembly line versus an intrinsic problem inherent in that model's
engineering? How do you separate one patient's physiology producing a drug
side effect versus an intrinsic problem with a drug that makes it
unacceptably dangerous?
Consider the oddity of those drug commercials on television. Fifteen
seconds of the purported therapeutic effort, followed by about 45 seconds
of a rapidly muttered list of horrific possible side effects. When the ad
is over, I can't remember a thing about what the pill is supposed to do,
except perhaps cause nausea, liver damage, projectile vomiting, a nasty
rash, a four-hour erection and sudden death. Sudden death is my favorite
because there is something comical about it being a side effect. What
exactly is the (BEG ITAL)main(END ITAL) effect in that case? Relief from
abdominal bloating?
And how many sudden deaths does it take until we say: "Enough," and
pull the drug off the market?
It's not an easy calculation. Six years ago, Vioxx, a powerful
anti-inflammatory, was withdrawn by the manufacturer because it was found
to increase the risk of heart attack and stroke from 0.75 percent per year
to 1.5 percent. The company was pilloried for not having owned up to this
earlier, but some rheumatologists were furious that the drug was forced off
the market at all. They had patients with crippling arthritis who had
achieved a functioning life with Vioxx, for which they were quite willing
to risk a long-shot cardiac complication. The public furor denied them the
choice.
And don't imagine that we do not coldly calculate the price of a human
life. In 1974, the speed limit was lowered to 55 mph to conserve oil. That
also led to a dramatic drop in traffic fatalities -- approximately 3,000
lives every year. This didn't stop us, after the oil crisis, from raising
the speed limit back to 65 and beyond -- knowing that thousands of
Americans would die as a result.
The calculation was never explicit but it was nevertheless real. We
were quite prepared to trade away a finite number of human lives for speed,
and for the efficiency and convenience that come with it.
This is not to let Toyota off the hook simply because all products
carry risk. Toyota executives have already admitted that they had
underplayed the reports of sticking accelerators. They seem finally to have
made a very serious, almost frantic, effort to correct what can be
corrected -- the floor mat and sticky accelerator problem -- while
continuing to investigate the more elusive possibility (never proved,
perhaps never provable) of some additional electronic glitch.
But it is no disrespect to the memory of those killed, and the sorrow
of those left behind, to simply admit that even the highest technology
produced by the world's finest companies can be fallible and fatal, and
that the intelligent response is not rage and retribution but sober
remediation and recognition of the very high price we pay -- willingly pay
-- for modernity with all its wondrous, dangerous bounty.
Charles Krauthammer's e-mail address is letters
(at)charleskrauthammer.com.
