Tuesday, September 27, 2005

Company Ethics

As this is from the general world in which I live and work, I thought this article was interesting. Guidant has been taking a lot of hits recently (google "guidant recall" for more articles than you'll care to read), and many of those were somewhat defendable, but I was suprised to hear about this. It seems to me, and maybe I'm naive, like a pretty clear line was crossed with this tactic.

By January, about 80 cardiologists nationwide completed an evaluation run by the Guidant Corporation of one of its products, an improved electrical component, known as a lead, that connects an implanted cardiac device to the heart.

In exchange for implanting the lead in three patients and completing five survey forms, each physician received $1,000 from Guidant.

...

"The primary purpose of the study was to get feedback on how well the system worked," said Dr. Wayne O. Adkisson, a cardiologist in Portsmouth, Va., who took part.

The program did generate feedback. But internal Guidant documents and e-mail messages provided to The New York Times suggest that the initiative also had another apparent goal - increasing sales of the company's most sophisticated and expensive heart devices. Those devices are advanced pacemakers called cardiac resynchronization therapy devices, or C.R.T.'s. They cost about $29,000 each.

The program proved so successful in increasing Guidant C.R.T. sales that when the survey ended in January, company executives sent around congratulatory e-mail messages, the records show. "It generated 300+ implants," one January e-mail message stated. "Let's say that just 25% were incremental ... that yields >$2 million in new sales with physicians who are not necessarily Guidant friendly. We paid each physician who completed all five surveys $1,000 so our total cost was $80,000.

Shouldn't doctors know better?

Wednesday, September 21, 2005

The Vioxx Trial

A good post on the Merck trial at In The Pipeline...

Tuesday, September 20, 2005

Aging

Klotho is a gene that adds an extra 30% on to the lifespan of mice when they receive an extra copy of the gene. Previously, it was shown that restricting caloric intake in mice produced the same effect, although similar studies in larger animals didn't have the same results. It remains to be seen if the Klotho gene will have an effect in larger animals, but would raise some interesting questions if it someday could be applied to humans. There is certainly an ethical responsibility to sustain life, but is there one to extend life? Particularly if increasing one's life span also increases the chances of contracting an illness like heart disease, etc...? Would insurance companies pay for gene therapy to insert an extra Klotho gene or for a prescription drug that boosts the effectivness of the Klotho gene product?

Monday, September 12, 2005

Bad Science Writing

Why does the public have a natural distrust of all things scientific? Okay, maybe that's a bit simplistic and over-generalized, but it definitely has an element of truth. We tend not to trust man-made things as much as "all-natural" ones. I've never fully understood it. Anyway, I stumbled upon this article through a link at Instapundit (a good resource, btw), which might explain in part how it happens.

I'd a couple of more reasons in why science stories get a bad wrap in the popular media.
1. Scientist themselves trying to overhype or overplay the importance of their own discovery
2. Misinterpretation of scientific findings by drawing firm conclusions inappropriately (for example, the conclusions of many scientific papers are "correlations" or "increased risk", etc...and these are misconstrued as stone cold fact by too many)
3. Overrepresentation of the importance of a single study/paper/finding...in other words, not holding findings up in the context of all the other work that's been done in the field, and showing how it fits in; sensationalizing.

This is a great point too...

"Last month there was an interesting essay in the journal PLoS Medicine, about how most brand new research findings will turn out to be false (www.tinyurl.com/ceq33). It predictably generated a small flurry of ecstatic pieces from humanities graduates in the media, along the lines of science is made-up, self-aggrandising, hegemony-maintaining, transient fad nonsense; and this is the perfect example of the parody hypothesis that we'll see later. Scientists know how to read a paper. That's what they do for a living: read papers, pick them apart, pull out what's good and bad."

When it comes right down ot it, reading scientific papers is like reading a different language and too few journalists are interested in doing it right. And the public doesn't know any better, or doesn't care to. Both science journalists and scientists themselves need to a better job of communicating to the masses....

National Geographic

If you haven't seen it, go find it at your local library or elsewhere. National Geographic (July, 2005 issue) has an excellent story about the embryonic stem cell debate, explaining many aspects much better than I could hope to. And it is a very fair and balanced view of the topic, giving you a bit of both sides. Here's what the editor says about it...

"A story about stem cells is a story about hope, which my dictionary tells me is 'to cherish a desire.' For Dean Richardson, a former deputy sherriff in Canon City, CO, hope appeared in July 2003 when doctors at Northwestern University in Chicago treated him with stem cells from his own bone marrow in an attempt to break the grip of multiple sclerosis, a degenerative disease that had confined him to a wheelchair. The treatment seems to have worked. Richardson's wheelchair is gone, along with any active signs of the disease. Similar therapies have shown promise for curing certain cancers and repairing hearts.

If debilitating illness can be conquered with stem cell therapy, why is it so controversial? Isn't it a medical miracle to be celebrated? Yes and no. Though we stand on the threshold of the realm of possibility, we are not yet inside it. The doors opened by science include one marked 'Moral Dilemma.' Many scientists believe that stem cells from human embryos offer even more hope for cures than the ones found in bone marrow--the kind that helped Dean Richardson. An editorial in the
New England Journal of Medicine called embryonic stem cell research 'the greatest biomedical promise of our time'. Yet to destroy embryos to create stem cell therapies is an unforgivable obstacle for many people. So ethical argument mixes with scientific process. Hope must break through the rhetoric.

My own hope, the desire I cherish, is that we can freely discuss the complex, sometimes uncomfortable, friction between science and ethics. That's what our stem cells story is all about."

Amen to that.

Maybe a snippet or two from the article in a bit...

Thursday, September 01, 2005

Separation of Church and State

It has always been a topic of confusion for me. We are a nation founded on the separation of church and state. But for many people, tenets of their religion are not only a matter of faith for them, but of objective reality, as well. So, if the government is run by the will of the people, and the will of the people reflects religious beliefs, where do we draw the line? If I believe that the bible tells me that life begins when the sperm enters the egg and creates an embryo, is that necessarily true? Or does it begin when it's implanted into a womb and begins to divide? Or that life was created and evolved in the way described by Intelligent Design theory? And should I be able to demand that policy be made to support this belief? It seems like that would be legislating the morality of a religion, and therefore not a separation of church and state. So, how should a government create legislation and policy? George Will clarified the issue for me (who I rarely agree with, btw) in a July 4th issue of Newsweek.

"The problem with intelligent-design theory is not that it is false but that it is not falsifiable: Not being susceptible to contradicting evidence, it is not a testable hypothesis. Hence it is not a scientific but a creedal tenet—a matter of faith, unsuited to a public school's science curriculum."

What? Waaaa!!?? You need evidence to make decisions?

This quote is great, because it illustrates a good point. The idea of Intelligent Design is in a sense, diabolical, because it inherently tries to place itself on a level playing field with science, characterizing science as a "theory". Really, science is much more than that, and it sometimes gets a bad rap. Shouldn't we demand that the laws and policies that govern us have some basis in repeatable, verifiable evidence? Isn't that what the scientific method is all about?