Chapter 41 Exercises

Thirty-two items in six lettered sections. Items marked † are the harder ones — they require you to build an argument or a study design rather than recall a distinction. No answers are provided here; that is deliberate, and it is the same reason Chapter 5 stopped giving them.

One rule applies throughout, and it is the chapter's rule: do not name a private individual in any answer. Not a celebrity, not an influencer, not a forum poster, not a person you know. Characterize claims and behaviors by type. If an exercise seems to require a name, that is the exercise.

Section A — Naming, brands, and genericization

41.1 Write out the five products named in §41.2 as a table with four columns: molecule, brand, route, indication family. Then, without looking, write down which two share a molecule with a third product not in your table.

41.2 Explain in two sentences the difference between a generic name and a brand name, using a molecule other than semaglutide as your example.

41.3 A friend says: "Ozempic and Wegovy are different drugs." Give the sense in which that sentence is false and the sense in which it is true. Then write the one-sentence version you would actually say to them.

41.4 † §41.1 gives a five-rung ladder of genericization. Pick a different genericized brand name — from any industry — and place it on the same ladder, giving a real example of usage at each rung it has reached. Where it stops, say why you think it stopped.

41.5 Chapter 1 §1.8 introduced naming stems. Given only the names liraglutide, dulaglutide, and tirzepatide, what can you say about the first two that you cannot say with the same confidence about the third? What would you check?

41.6 † Genericization is usually described as a problem for trademark owners. Construct the argument that in this case it is also a problem for the trademark owner's competitors, and identify who bears the largest share of the cost.

Section B — The clinical consequences

41.7 List the four harms §41.2 attributes to genericization. For each, name the specific person or system that absorbs the cost.

41.8 A patient tells a clinician they are "on Ozempic." Name five distinct facts the clinician still does not know, and rank them by how much each could change a clinical decision.

41.9 † Design the single question a clinician should ask to recover the most information in the least time. Justify your choice against two alternatives you rejected, and say what your question would still miss.

41.10 Explain why a formulary has no entry for "semaglutide, generally," and what it has entries for instead. Then explain why that fact makes brand-name shorthand expensive rather than merely imprecise.

41.11 † The 🩺 callout in §41.8 argues that misattribution in adverse-event reporting is directionally biased toward the famous brand rather than randomly distributed. Reconstruct that argument in your own words, then state one way it could be wrong.

Section C — Evaluate this claim

For each item: state the claim precisely enough to be evaluated (population, endpoint, timeframe), assign a rating from the book's system or explain why the system does not apply, give a one-sentence reason, and name what would change your rating.

41.12 "You can tell who's on it just by looking at their face."

41.13 "Everyone in that industry is using these drugs."

41.14 † "Public attention to these drugs has been good for patients."

41.15 "The generic-name confusion is a media invention; real patients know what they're taking."

41.16 † "These drugs have made weight stigma worse, because now thinness is purchasable."

41.17 † "These drugs have made weight stigma better, because obesity is now understood as biological."

41.18 "Calling it 'Ozempic face' is fine — it's just a description of something real."

Section D — Disclosure

41.19 Write the strongest single-paragraph case for a disclosure obligation, without using any example that identifies a person. Then write the strongest single-paragraph case against. Do not indicate which you believe.

41.20 §41.4 distinguishes silence from misattribution. State that distinction in one sentence, then give two hypothetical, non-identifying scenarios: one that falls clearly on each side, and one you find genuinely hard to place.

41.21 † The chapter claims the line at "pharmacological" is intuitive but not principled. Try to defend the line anyway: construct the best principled version you can. Then say honestly whether it survives the adjacent cases in §41.4.

41.22 Explain why the claim "public figures have an obligation to disclose" is NOT RATED rather than rated ❌. Then write an empirical claim in the same territory that could be rated, and rate it.

41.23 † A commercial interest is said to strengthen the case for scrutiny. Specify exactly what is being scrutinized in that case — the person, the silence, or something else — and why that specification matters to the chapter's refusal to impose a duty.

Section E — Speculation, jokes, and social facts

41.24 Reproduce the nine-observation table from §41.5 from memory, then add two observations of your own that the system would also absorb.

41.25 State, in one sentence each, why the following do not rescue a speculation: "I'm just saying it's likely," "everyone knows," and "it's obvious from the pictures."

41.26 † The chapter says the epistemic objection to speculation is stronger than the moral one. Stronger in what sense? Write the version of that argument you would use with someone who explicitly rejects the moral objection, and identify the premise they must still grant.

41.27 §41.6 claims a joke transmits a social fact that no evidence supports. Define "social fact" in your own words and give an example from a domain unrelated to medicine.

41.28 † Take any claim from Part III of this book that you rated ❌ or 🔬. Write the joke version of it — the compressed form that would circulate. Then list what the joke had to discard, item by item, and say which discarded item you would most want back.

41.29 Explain why "it's a joke" functions as a defense against evaluation, and what that tells you about where the joke's payload ends up.

Section F — Applied

41.30 For one week, keep a tally — not of who you think is using anything, but of how many times you encounter the brand name used to mean the class. Note the source type each time (advertisement, video, conversation, news, comment). Do not record any individual's name.

41.31 † Complete the Cultural Drift Log from the chapter's dossier section for one compound in your dossier. Then write a paragraph on which of the four sources came closest to your Field 5, and whether that surprised you.

41.32 Write the five practices from §41.9 on a card. At the end of a week, mark which one you actually used and which one you found hardest. If the hardest was "decline to speculate," write two sentences on what made it hard — the honest version, not the flattering one.