Category: Ethics
R&D and the High Cost of Drugs
Until a year ago very few people had ever heard of Martin Shkreli. In 2015 the then-32-year-old CEO of Turing Pharmaceuticals LLC became the poster boy for Big Pharma eXXXcesses when Turing acquired rights to Daraprim, an antiparasitic drug used widely to treat toxoplasmosis. The acquisition itself wasn’t particularly controversial. Raising the price of Daraprim from $13.50 per pill to $750 per...
Is there a distinct standard of care for “integrative” physicians? The Woliner case
We at SBM argue that there should be a single, science-based standard of care in medicine. Unfortunately, with the rise of "complementary and alternative medicine" (CAM) also called "integrative medicine," there is a separate standard emerging that allows CAM practitioners to get away with using unproven and disproven treatments. The case of Dr. Kenneth Woliner illustrates this problem.
Researching the Magic of Homeopathy
A Canadian academic, Dr. Mark Loeb, who is a respected infectious disease researcher who knows how to conduct high quality research, wants to study homeopathic nosodes. Nosodes are essentially homeopathic vaccines. Tim Caulfield, a Canadian professor of health law and policy, thinks the study is misguided and unethical. The two are having a respectful public debate about the risks and merits of...
The cruel sham that will not die: Right-to-try marches on in California and beyond
State "right-to-try" bills are springing up like kudzu all over the US. Their advocates promise that they would save lives by allowing terminally ill patients access to experimental therapeutics. This is a delusion; even the most fervent supporters of right-to-try have trouble pointing to a single patient who has benefited from such a law. In reality, right-to-try laws are a cruel sham...
Pharmacy and homeopathy: Will the profession change, or will change be forced upon it?
Retail pharmacy is giving itself a credibility problem. While pharmacists are highly trusted health professionals, there are increasing questions about the products sold in pharmacies. Many of the non-prescription products that you can find aren’t backed by good evidence. And the number of dubious products seems to be growing. Homeopathy is an extreme example. Homeopathic “remedies” look like conventional medicine, but unlike...
What’s the harm? Stem cell tourism edition
Stem cells have become big business. Offshore clinics claim to use stem cells to treat anything from aging, diabetes, stroke, cancer, and even autism, all without compelling evidence that these treatments have any meaningful effect. Unfortunately, the potential for harm, both financial and to health, is high, as the case of Jim Gass demonstrates.
Parents Convicted in Death of Toddler
This is a very sad and tragic case, and I have great sympathy for the extended family of Ezekiel Stephan, the 19-month-old who died of meningitis four years ago. In my opinion, there are many victims in this case. The jury, apparently, agreed. Yesterday they returned a guilty verdict for Ezekiel’s parents, David and Collet Stephan, who now face sentencing for failing...
Academic Consortium plan: force medical residents to practice integrative medicine
“Integrative medicine” (IM) is an ideological movement within medicine driven in large part by those whose livelihoods depend on its continued existence. This includes both those with positions in academic medicine and individual practitioners who use the IM brand to attract patients. Despite IM and its antecedents (alternative, complementary, alternative and complementary, complementary and integrative) having been around for about a quarter...
Patient Beware: Off-label drug promotion by pharmaceutical companies
Pharmaceutical companies and their sales reps can distribute information, such as medical journal articles, about unapproved (“off-label“) uses of their drugs as long as they adhere to FDA guidelines. However, the FDA takes the position that this information must be distributed separately from information that is “promotional in nature,” i.e., for marketing purposes, a position that is now open to question. Off-label...
Reporting results from clinical trials is vital for science-based medicine
Clinical trials must report on their outcomes, irrespective their results. Doctors and their patients need all the information, not just the good news stories, to make informed decisions.