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I do not want to bash medical science. Every field of human endeavor has problems, and the longer it has been around and the more established it is, the more th
by DanielBMarkham 10y ago
I do not want to bash medical science. Every field of human endeavor has problems, and the longer it has been around and the more established it is, the more the cruft and the bigger the problems.
I can't help but notice, however, that we're killing a ton of people because of the inefficiency of our research system. Fifty or sixty years ago, if we had simply taken people who were going to die soon and had them voluntarily submit to A/B testing? How many millions would be saved by now? How much better would it have been to have died knowing you were directly helping in a simple experiment that one day would save all of those lives?
Instead we spend tens of billions, drugs take decades to get approval, and we have people dying of infections for which we have no drugs to address.
We may have reached an inflection point here, folks. Instead of perfect safety, a better metric might be the most medical progress over the shortest amount of time -- in an ethical fashion, of course.
- rscho 10y agoThe goal of the medical system, as it currently stands, is explicitly and literally geared at making people feel cared for. Which is quite antagonistic to your above statement, which stems from utilitarian philosophy. The consequences are simple: in the recent years, we have seen a huge push for "medical humanities" in medical education (aimed at perfecting the doctor-patient relationship). But for scientific medical education? Niet. Nada. But people seem to like it that way...
- DanielBMarkham 10y agoI hate making moral arguments, but dang. I'm not sure it's entirely utilitarian. People like to feel there is meaning to their life, some sort of story. Given a chance to directly contribute to science in an understandable way in their last days? I think for many it is the most humane thing to do. (But not all, of course) [1] Note that the key here is understandable, which would eliminate double-blind studies. 1. Related -- https://en.wikipedia.org/wiki/Man%27s_Search_for_Meaning https://en.wikipedia.org/wiki/Man%27s_Search_for_Meaning
- notahacker 10y agoQuite apart from the ethical concerns, I can't really imagine a shared characteristic in a set of test subjects for an experimental procedure/treatment that could undermine the results more than expected to die soon for unrelated reason
- DanielBMarkham 10y agoThat's a sample size and actuarial question.
- mcherm 10y agoNo. Confounding variables are NOT fixed by using larger sample sizes.
- Fomite 10y agoAs a trained epidemiologist, I regret that I have but one upvote to give.
- notahacker 10y agoEven if an abundance of patients with sufficiently similar terminal illnesses at sufficiently similar stages willing to forego their entitlement to other treatment or pain relief in the interests of medical science exists, I can't see "although several patients died during the trial the increase in death rate wasn't statistically significant and whilst possible side effects such as nausea and extreme fatigue were reported, these were also near-universal in the control group" as an advance in testing procedures...