Policy and Ethics

Let's pretend that you're a government funded scientist, like many professors and academics. Your entire livelihood depends on the largesse of taxpayers, politicians, and bureaucrats. If you asked the government for $1 million to fund your lab and its response was, "We love your research so much, here's $2.5 million," what would be your response?

Professors I know would have been popping champagne bottles (microbiologists, after all, like to drink), inviting the whole team to celebrate in stupefied disbelief. Everyone's jobs were secure, and they could continue their work studying a fascinating aspect of the natural world.

Some scientists, however, appear incapable of normal human emotion. Science magazine...

STAT recently interviewed U.S. FDA commissioner Scott Gottlieb of the Food and Drug Administration on the proposals to curb drug costs; two quotes stand out:  

“Does the disclosure of the price information provide appropriate balance to the consumer — like, is the information about the cost of the drug and the accessibility of the drug important at the time that they’re seeing the advertisement, in order to provide appropriate disclosure and fair balance in the advertisement?”  

A fair but irrelevant question. Direct to...

A premature infant is born with a form of severe lung injury that carries a 20% chance of survival. Her physician decides to throw a medical “Hail Mary” and try an untested adult technique to bypass the injured lungs. The infant survives, and after a few more tries, the physician realizes that the survival rate may be as high as 80% with this new treatment. Does he know enough that the treatment should become standard practice, or is a randomized clinical trial required?

In modern medicine, randomized clinical trials (RCTs) are a very effective way to determine the efficacy of different treatments. In an RCT, patients are randomly assigned to receive one of the treatments under study, and the differences in their outcomes are measured. Randomization can be a very helpful tool to...

In 2009 the U.S. government attended the United Nations Climate Change Conference in Copenhagen and pledged to reduce overall greenhouse gas emissions 17 percent by 2020.

To make it happen, the Obama administration directed the U.S. Environmental Protection Agency to lead the way starting with carbon dioxide (CO2) and that resulted in the Clean Power Plan (CPP) in 2015. While the goal was laudable, no one is in favor of more pollution, it was a blunt instrument because it unfairly penalized fossil fuel power plants in order to provide nearly half the overall reductions the Obama administration sought under the Paris Agreement commitment. Energy is a basic need so it didn't make much sense to unfairly penalize the poor with increased costs for unknown benefit.

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With the term of controversial International Agency for Research on Cancer (IARC) Director Christopher Wild thankfully at an end, speculation about the new head of the embattled UN agency was rampant, probably for the first time in its history.

The reason there was so much concern is simple: They have lost their way. They no longer do science, they do activism and call it epidemiology. The inmates in epidemiology, from Martyn Smith to Chris Portier, have been running the asylum, they have exploited IARC's bizarre 'five orders of magnitude for dose determines hazard' to get pet causes for trial lawyers a veil of legitimacy, and the public and government agencies no longer trust it. Before making any decisions on its funding future, U.S. policymakers wanted to know if IARC was...

In the grand tradition of misidentifying problems and offering proposals that won’t work, the city council of Washington, D.C. wants to force manufacturers of flushable toilet wipes to change the label to “non-flushable.” There are four reasons it's bad policy.

First, flushable wipes are flushable. It's true some older versions were not perfect, but newer ones are made of cellulose fibers – just like toilet paper. That means they are flushable and break down after being submerged in water. Yes, some varieties can take longer to disintegrate than toilet paper, but they lack the plastic fibers found in the non-...

There is no denying when public figures experience medical issues they can draw greater awareness and attention toward disease prevention; informing society and providing beneficial education. But, the hospitalization of the First Lady, who is thankfully expected to make a full recovery for a “benign kidney condition,” raises concerns surrounding the intersection of patient privacy and a loved one seeking and holding elective office. Should an unelected citizen be unduly compelled to reveal any aspect of their health status? 

Many would argue that when someone runs for public office, everything is fair game. Perhaps it is time to re-examine that issue. Where...

US news media headlines appear daily on the so-called “opioid crisis”.  A major thread in public policy discussions is an asserted need to “solve” the crisis by limiting production of opioid analgesics and reducing medical exposure to potentially addicting drugs.   But are such steps actually a remedy?   Will US addiction and overdose problems respond favorably to such a one-size-fits-all policy?  Almost certainly not.

A recent analysis has been performed on data downloaded from the US Centers for Disease Control and Prevention and the US Agency for Healthcare Research Quality (1).  The data characterize medical opioid prescribing, opioid overdose-related deaths from legal and illegal drugs and hospital emergency room admissions from 1999 to 2016 for 50 US States and District of...

In the name of battling our misnamed "opioid epidemic," (1) which has only resulted in making things worse (2) there is a casualty that is far worse than anything that could be caused by a drug - the loss of our right to make healthcare decisions with our own providers and the right to privacy. A whistleblower document from Walmart which I obtained discusses "scoring" patients based on their medical and prescription history. It should terrify you. And it will. Following are some passages from the seven-page document, which, despite its benign-sounding title, is anything but. 

What you will read is...

With right-to-die legislation in its fledgling stages in the United States, the bioethics surrounding assisted suicide are in play as they haven’t been in the past. Traditionally, arguments to enact these laws are fashioned around the notion of liberating a patient from terminal usually insufferable disease. But, the recent intentional death by 104-year-old scientist David Goodall via euthanasia brings to the forefront whether to deem deterioration from advanced aging as another reasonable consideration.

So determined was the British-born scholar, who failed in prior attempts in his home country of Australia where it...