Imagine a world where the FDA and other regulatory bodies in other jurisdictions like Australia could approve drugs without requiring robust evidence that they actually work. Sounds absurd, right? But if you squint at the incentives, it's not entirely incomprehensible.
On the surface, the FDA et al. exists to protect the public from snake-oil and bad science. Approving a drug should, in principle, require a demonstration that the treatment has more than a placebo effect, that benefits outweigh risks, and that dosing is tolerable. Skip the evidence, and you're entering a world where approval is essentially a marketing stamp: "This chemical is officially allowed for human consumption. Effectiveness optional."
So why might anyone advocate for this?
1. Economic acceleration
Pharmaceutical companies operate on a brutal clock. Bringing a drug to market under today's standards often takes 10–15 years and billions of dollars. Loosening efficacy requirements would rocket drugs onto shelves. Investors love it. Entrepreneurs love it. Patients… well, they may not notice until the bill comes due.
2. Political optics
Politicians can wave freshly approved drugs around as evidence they "care about health." Efficacy? Who needs it when approval alone can be spun as progress? This is especially tempting in crises: new disease, sudden epidemic, or even chronic illnesses with no existing solutions. Approval becomes a symbol, not a science.
3. Placebo and belief economics
Some argue that even an unproven drug can "work" if people believe in it. This is the ultimate postmodern rationalisation: perception equals effect. In a world of wellness culture, celebrity endorsements, and TikTok medical advice, belief can be commodified. The FDA stamp merely legitimises the placebo as a commercial product.
4. Regulatory capture and industry lobbying
The argument is less lofty and more cynical here: if the regulators are effectively beholden to industry, removing the need for hard evidence is a win–win for corporate lobbying. Companies save time and money; regulators boast higher "approval numbers," which politically looks productive. Science takes a back seat.
5. Philosophical libertarianism
A small but vocal faction might argue: why should the FDA restrict freedom of choice? If adults want to try a chemical with a 50% chance of working (or 0%), why deny them? Evidence becomes a suggestion, not a requirement, and risk assessment moves to the individual.
The dark undercurrent is obvious. Approving drugs without evidence erodes trust, inflates healthcare costs, and risks widespread harm. The FDA's credibility is a fragile ecosystem: once "proof optional" becomes policy, the public has no reliable anchor between marketing hype and actual efficacy. People get sick, die, or waste money on useless treatments — while regulators and politicians pat themselves on the back.
From a techno-sceptical standpoint, this hypothetical exposes the tension between symbolic authority, economic incentives, and scientific rigour. The FDA is designed to gatekeep knowledge about reality — what works and what doesn't. Removing that guardrail doesn't liberate people; it commodifies ignorance, turning hope into a purchasable, FDA-approved placebo.
In other words, if the FDA ever said "we don't need evidence", the world wouldn't just get faster access to drugs. It would get a fully institutionalised illusion of competence. And the irony is, some might cheer that illusion.
https://alexberenson.substack.com/p/why-would-anyone-want-the-fda-to