Conservatism, Consumer Choice, and the Food and Drug Administration during the Reagan Era: A Prescription for Scandal by Lucas Richert (review)

Lucas Richert frames the Food and Drug Administration (fda) within the rise of conservatism, a force within the Republican Party and one that attracted Ronald Reagan as perhaps its exemplar. In this sense Conservatism, Consumer Choice, and the Food and Drug Administration during the Reagan Era is as much about the fda as it is about the ideology that has attempted to constrict the agency. In this context the book may be best understood as an example of the triumph of conservatism in modern American life. Scholars have produced many studies of the pharmaceutical industry and the fda. What Richert delivers is a political narrative of conservatism within the context of capitalism, scientific research, and the rise and fall of ideologies.

The author begins his treatment with a brief history of the fda, tracing its roots to what one might call its proto inception in the US State Department in 1839. Much credit of course is due Upton Sinclair and Harvey Wiley in the first decade of the twentieth century, but the story is too well-known to merit treatment. Within this historical framework it is useful to trace changes in the scope of the fda’s authority. Over the short term Richert focuses sharply on Reagan as the catalyst of modern conservatism. Well-known was the president’s penchant for portraying government as antithetical to freedom. Accordingly the discourse shifted toward the prospect of shrinking the size and scope of government. As president, Reagan had the federal government in mind, but plenty of his sycophants applied his principles to state and local governments. Reagan took aim at a number of federal agencies including the fda. In this context arose questions about the fda’s actions. To what degree did the fda have the authority to regulate drugs and other substances that Americans ingested? Did this authority conflict with freedom of choice? Did the fda operate outside the confines of capitalism?

Richert explores the tensions within such inquiries, but authoritative judgments are difficult to make. The author stretches his chronology between 1974 and 2008 but spends much of his energy examining the 1970s and 1980s. During this era, pharmaceutical companies were eager that Reagan, certainly by the 1980s, diminish the regulatory powers of the fda. In this context the innovation argument came to the fore as drug companies argued that federal regulations penalized them for pursuing new lines of research and developing truly novel therapies. Consumers too voiced concerns. They wanted greater freedom in selecting medicinal drugs. Seriously ill Americans wished to try experimental drugs even if the fda branded them unsafe. The battle over the fda fulminated during the 1970s, when high inflation and unemployment undermined confidence in government. Government itself vacillated. Whereas President Jimmy Carter wondered whether the fda had too cozy a relationship with drug companies, Reagan perceived a desire to over regulate what should be a free market.

Lucas Richert does well to examine the transition, certainly by the 1980s, of drug companies from a chemical to a biological model. That is, the search for new chemical compounds to treat ailments began to cede ground to molecular biology, which sought an understanding of pathologies and corrective actions by the body at a molecular level. What Richert does not provide is the broader context in which a revolution is occurring in the science of genetics and the technologies it produces. Scholars are studying this phenomenon in agriculture and the agricultural sciences. The time has come to expand this approach to other disciplines that broach the biological sciences. Because the fda and drug companies are legitimately engaged in the study of the human body, they must be part of this discourse. Perhaps another specialist might illuminate these issues in the future. With the envisioning of rapid progress in genetics and biotechnology, one wondered whether the fda was agile enough to...