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Editorial: Freedom!
Who can forget the final words of Mel Gibson in the movie Braveheart as his body was being pulled apart, or the images of battles throughout the years and the sacrifices of so many so that we can live as free men and women. Sadly, it seems we don't really appreciate what we have here in the U.S. It is apparent, however, that so many others throughout the world will give almost anything to experience the freedoms that we enjoy.
One thing we seem to have is a majority of our citizens that would be economically categorized as "middle-class", with smaller percentages in the "rich-class", and "poor-class." In many other countries, it seems the middle-class is much smaller with fewer in the rich-class and many, many more in the poor-class. One has to wonder then, is it the working middle-class that largely contributes to the national economics and the "life-style" we enjoy in the U.S.; the "life-style" that so many throughout the world would love to enjoy.
All three economic classes are quite important in any society for their contributions. At least, here in the U.S., each individual has opportunities to change from one economic class to another, based upon the decisions we individually make along with other contributing factors. Many of us were told when we were children, "You can be anything you want to be if you work hard at it." Whether or not things work out the way we want, we do have the freedom to try if we wish; for some it may be more difficult than for others, but at least we have the freedom to try.
A concern I have is that many of our freedoms are being slowly taken away. The freedoms upon which this country was founded are not as numerous and varied as they used to be. At the rate we are going, what freedoms will we have left in 10 or 20 years? Our options are becoming more and more limited. There are more and more "roadblocks" being erected in the form of laws, regulations, and actions limiting what we can do. I am reminded of the limiting of our freedoms every time I fly somewhere, try to cash a check, go into a government building, or any of several other activities that used to be so easy.
In our profession, there are many threats to the way we practice pharmacy. To those that have been around 25 or more years, think about the freedoms we used to have in our profession compared to today. We no longer control our profession; we are controlled in it.
Freedom in the U.S. is not lost by a single catastrophic event (even though some individual freedoms may be) but slowly, over time, by changes (that may be well-intentioned) that are made without considering all the consequences. At some point we are each going to have to stand up and be counted upon to defend and maintain our freedoms. If not, one has to think about what has been said, "If you don't stand for something, you will fall for anything." One thing is for sure, we cannot continue down the road we are following without some major changes. Freedom will require it.
Loyd V. Allen, Jr., PhD, RPh
Editor-in-Chief
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In a follow-up to the 4-part series of articles on hazardous drugs that are being published in IJPC, please note the following:
Process for updating the list of hazardous drugs (Appendix A) for the NIOSH Alert on Hazardous Drugs
NIOSH Docket #105
The National Institute for Occupational Safety and Health is requesting public comment on the definition of hazardous drugs and adding new drugs to the existing list of hazardous drugs in the workplace.
The NIOSH Alert: Preventing Occupational Exposures to Antineoplastic and Other Hazardous Drugs in Health Care Settings was published in September 2004 ( http://www.cdc.gov/niosh/docs/2004-165/ ). Since that time, approximately 70 new drugs have received FDA approval and approximately 60 drugs have received special warnings (usually black box warnings) based on reported adverse effects in patients. An additional 18 drugs were included from the updated NIH Hazardous Drug List. From this list of approximately 150 drugs, 62 drugs were determined to have one or more characteristic of a hazardous drug.
NIOSH has assessed the scientific literature and found no reason to change the definition of hazardous drugs at this time. NIOSH has also evaluated the information available for the three groups of drugs and identified a subset of 62 drugs that may be hazardous to health care workers who handle them.
This preliminary list represents drugs that fit one or more of the characteristics of a hazardous drug as defined by NIOSH.
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