Policy and Ethics

Glyphosate, a component of the popular herbicide commonly known as Roundup in the United States, has been placed on California's Proposition 65 list, which requires a cancer warning label on it. It now joins products like coffee, where a Prop 65 warning label is ubiquitous in every Starbucks, in baffling tourists with how silly our labels are.

After all, if it causes cancer, just ban it. Right?

That's the problem. No regulatory body can find evidence it harms anyone or anything other than what it is supposed to harm, much less that it causes any cancer in people.

How is a system designed to protect California citizens...

Given the title of the article and the topic, I am going to make a Conflict of Interest disclosure - my son works for Google and I remain immensely proud of him even if someone claims Google controlled the tone of my article due to that.(1)

Now that we got that out of the way let us consider concern about academic conflicts of interest. An advocacy group, the Campaign for Accountability (CfA), which is funded by a competitor of Google, published a report on how Google pays academics to research topics and complains that a disclosure of Google’s funding was in some cases absent.

Some of the people included in this report...

Bloomberg Businessweek has written another anti-Monsanto article, nothing special about that, but this time they did something new; they consciously sought to interfere in an environmental lawsuit against Monsanto in California and to promote fear and doubt about the science community and regulators who overwhelmingly accept the science consensus on genetically-modified foods - colloquially called GMOs, because Monsanto received a patent on that one kind of genetic engineering.

It's not the first time members of this team of Peter Waldman, Lydia Mulvany, Tiffany Stecker, and Joel Rosenblatt have...

An international team of medical experts recently published a global call to action in Science Translational Medicine in an effort to curb the unethical, unsubstantiated use of stem-cell based therapies driving medical tourism. Such ill-advised “stem cell” treatments have led to pediatric deaths in Germany, blindness in the United States, the closure of Italy’s Stamina Foundation to name a few as well as a variety of untoward effects given their lack of rigorous testing for safety and efficacy. 

With high price tags, so-called “stem-cell” clinics are designing therapies without evidence that serve to do harm, be ineffective, prey on the most vulnerable—potentially curtailing their ultimate treatment choices...

An abundance of caution, we have all heard the phrase. And while there are nuances, its gist is, for this particular situation we are extra careful. And in what situations does that apply? For the most part, situations in which there is a remote chance of a catastrophic outcome that puts its thumb on the scale when measuring risk and benefit. But like the thumb on the grocery scale, it throws off the whole enterprising of weighing choices and often has stealth costs of its own. These hidden costs can take the form of resources such as time and money. Most egregiously, they can infringe upon our rights. The quarantining of health care workers possibly exposed to Ebola was out of an abundance of caution. There is a cost to the scientific enterprise when we make decisions about our public...

Aside from eroding the invaluable doctor-patient relationship by monopolizing the clinician’s time for data entry, fragmenting access between institutions when patient sharing is commonplace and functioning more as a billing platform than a therapeutic asset, electronic medical records (EMRs) have not lived up to their promise. Though the concept seems like a panacea, patients and doctors don’t live in a theoretical world. They live in a real one. 

In this real world, each action has consequences. Some good, some bad. Hence, why the actual implementation of such a disruptive force as EMRs need also be held accountable for the adverse effects it generates. This...

There is a theoretical relationship between a nation’s wealth and the amount of pollution it emits.

Because a poor country has little manufacturing and few power plants, pollution is low. As the nation develops, perhaps by burning fossil fuels to produce electricity and operating manufacturing facilities to generate exports, it becomes wealthier. At the same time, however, it pollutes more than it ever has before.

Eventually, as the country becomes even wealthier, the people demand a cleaner environment. What was once a luxury (clean air and pure water) is demanded as a right. As a result, new regulations are enforced, cleaner technologies are implemented, and pollution decreases.

This pattern, known as the...

Dear CDC,

Yesterday a Texan named Tom called our office for some advice about his pain, so the call went to me. I told him I'd be happy to do whatever I could to help him. In retrospect, it was an empty promise.

The conversation was awful. Not only was his story difficult to hear, but the sum total of help I was able to give him was zero. Tom is just one of many collateral casualties of a brutal war against Americans in pain, which was orchestrated by the "Narcotic Nazis" at the CDC. I've read many stories about legitimate pain patients being denied opioid drugs, but it was profoundly upsetting to actually speak with one. Tom appeared to be nothing more than a fine man who did nothing wrong except...

I have repeatedly written about the vital need to stop one-size-fits-all approaches to complicated medical conditions and health policy as well as how important regional nuance is to solving these and more issues like healthcare-associated infections (HAIs). Identifying the unique interactions, behaviors and exposures of a community drives the en vogue "population health" trend from a patient perspective while optimizing the culture, complexity and effectiveness of local institutions and personnel.

So, when I recently attended the Committee on Reducing Infection...