Scott Alexander defends his criticism of the FDA's approval process in the infant fish oil case, arguing that systemic issues cause harmful delays even when the FDA follows its mandate. Longer summary

Scott Alexander responds to Kevin Drum's criticism of his interpretation of the infant fish oil story. He maintains that his account was substantially correct, despite some minor errors. Scott argues that the FDA's approval process, while following its mandate, causes unnecessary delays in life-saving treatments. He uses analogies to illustrate how the FDA's structure can be problematic even when individual employees perform well. Scott emphasizes that his criticism is not about the FDA failing its mandate, but about the design of the system itself causing delays in implementing known beneficial treatments. He concludes by addressing Drum's skepticism of FDA critics, arguing that anger towards the FDA often comes from personal experiences with its shortcomings. Shorter summary

Scott Alexander corrects and expands on the story of Omegaven, a life-saving infant nutritional fluid, using it to illustrate systemic issues with medical regulation and drug approval. Longer summary

Scott Alexander revisits a story about Omegaven, a fish-oil-based nutritional fluid for infants, correcting some details from his previous post. He explains how the fluid was discovered to prevent liver disease in infants requiring IV nutrition, and the challenges faced in getting it approved by the FDA. While the FDA comes off relatively well in the story, Scott argues that the real problem is the systemic hurdle of drug approval that makes everything in medicine illegal by default. He discusses how this hurdle makes scientific discoveries harder and potentially costs lives, even when many individuals involved are trying their best. Shorter summary