I call it "defensive" because the answer is not simply "yes" and I think it's a poor position to view clinical trials uncritically. Clinical trials may indeed

I call it "defensive" because the answer is not simply "yes" and I think it's a poor position to view clinical trials uncritically. Clinical trials may indeed work, but it's absolutely not clear that they are optimally designed. Although few people on this thread are experts, there are a plethora of different comments which illustrate the impossibility of perfect clinical trial design - there are always improvements that could be made and subjective decisions that have to be taken. The point that you make about pharma companies being profit-making companies could equally be phrased as a very strong criticism: that any pharma clinical trial design is likely to be heavily biased by their desire to sell their most profitable ("optimal") products.