Policy and Ethics

I wanted to spend a moment talking about the opioid crisis from a physician prescriber perspective. There are many types of pain, pain in our muscles and bones, what we call somatic pain; and pain in our organs, those ‘tummy’ pains we call visceral pains. I would suspect that most of the pain medications physicians prescribe are for those somatic pains. There is another distinction regarding pain that frequently gets overlooked in the heated opioid crisis, some pain is acute, from the moment of injury, and some pain is more chronic a result of the injury but later on. As a surgeon, my skill set resulted in inflicting acute pain, surgical pain and I want to spend a few minutes talking about how it might be treated to lessen the risk of ‘opioid dependence’ at least from surgical care. I...

Every so often, the world debates whether or not it should exterminate the only known samples of smallpox. So far, we always have decided to keep them around, just in case we need them for research or vaccine development.

To end this debate once and for all, David Boze wrote a piece for American Spectator, in which he proposed that we declare smallpox an endangered species. His tongue-in-cheek article highlighted some of the absurdities of the Endangered Species Act.

For instance, for a species to be declared "endangered," only one of five criteria have to be met. According to the U.S. Fish &...

The Associated Press headline itself is rather interesting: "Chinese nationals indicted on illegal drug manufacturing." And so is the story. Given that virtually all of the fentanyl and (far worse) fentanyl analogs are being made in China, it is no surprise that Chinese authorities discovered and closed down two fentanyl factories, which had the capacity to make tons of the drug. Make that drugs. Because this is the heart of the story. We are not talking about fentanyl itself, but rather, its "chemical cousins."

It may strike you as odd that drugs that were being made in China are legal in the United States. (1) How can this be possible? It turns out that what the Chinese were doing is conceptually identical to what I did for a...

Healthcare workers experience more non-fatal violence in the workplace than any other profession by a fairly large margin.  These assaults account for almost 70 percent of all non-fatal workplace violence causing days away from work in the United States.  In all-to-common scenarios, patients can be found hurling abuse toward employees of medical facilities and these scenes can be pretty frightening, not just for staff, but for other patients as well.  It is tough to tell what kind of person you're dealing with and a wrong move could cause you death and disability. 

In a recent ...

I do not know Dr. Andrew Kolodny,  personally, and, aside from one brief phone call last year, I have had no contact with him. Therefore I cannot know his motivation for becoming a driving force behind "opioid reform"— a concept which would border on hysterically funny if not for the tragedy that it is causing in this country. 

Dr. Kolodny, a psychiatrist, is the executive director of Physicians for Responsible Opioid Prescribing (PROP)—a group that played a significant role in creating the disastrous CDC Guideline for Prescribing Opioids for Chronic Pain (2016). The CDC ended up incorporating much of PROP's recommendations, which were supposedly designed to help the US mitigate the damage done by opioid (...

In foreign policy, it is difficult to state anything with certainty. Intelligence agencies have sources that journalists do not. As a result, publicly available information is often incomplete. For North Korea, this problem is made exponentially worse by the reclusive nature of the regime. All conclusions should be thought of as tentative.

Given those caveats, a team of researchers at Harvard's Belfer Center scoured the globe for whatever was publicly available on North Korea's biological weapons program. Referencing news articles, journal papers, expert interviews, and government reports, the team assembled a comprehensive study of the knowns and...

The bad news just keeps coming out of England with respect to the state of the National Health Service (NHS) and its rapidly eroding quality of care. Most recently, Professor Ted Baker-- the new chief hospital inspector-- declared it was “not fit for the 21st century.”

His first interview revealed his sense of urgency regarding the need to reverse the so-called “normalization” of “wholly unsatisfactory” treatment that endangers patients and guard against unacceptable and unsafe practices of “piling patients into corridors” that lack staffing for sufficient oversight as well as undermine patient privacy and...

It is Game On! at Commissioner Scott Gottlieb's U.S. Food and Drug Administration.

Recognizing the FDA lacks a direct role in drug pricing, his overarching strategy is to facilitate increasing market competition so as to drive down prices-- thereby increasing accessibility and innovation (see details of his Drug Competition Action Plan here). His parallel focus to achieve these goals is to curb abuses of the Orphan Drug Act (ODA). 

President Reagan signed the Orphan Drug Act in 1983 in an attempt to incentivize discovery. Smaller population ...

Gary Ruskin, the chief junkyard dog of US Right To Know, an industry front group created by Organic Consumers Association to harass and intimidate scientists, has managed to pay-to-publish a Short Article which allows him to claim he has been in a peer-reviewed journal.

That has to be placed in context. In an open-access digital world, where thousands of predatory journals now exist which allow anyone to buy the right to claim they have been peer-reviewed, being peer-reviewed doesn't mean what it used to mean. If I gather five astrologers to review some article on astrology and put it in an online astrology...

In order to capitalize on current events and our hyperpartisan climate, science news outlets increasingly feel the need to weigh in on how day-to-day political affairs will affect science.

Originally in Nature News and reprinted by Scientific American, an article published on Monday boldly proclaims, "What Germany's election results mean for science." The authors suggest tighter regulations on GMOs and ambiguity on energy/climate policy.

Here's a better answer: The German election means nothing for science. Absolutely nothing. Nobody with any credibility looks to Germany for leadership on scientific issues. There are multiple reasons for this...