Trials on trial
Osagie K. Obasogie’s criticism of clinical trials contains a number of misleading assumptions, including the implication that a clinical trial is by definition a drug trial (22 January, p 24).
Clinical trials provide the best evidence for efficacy, safety and cost-effectiveness of many interventions, be they behavioural change, surgery, screening or pharmaceuticals. The increase in the number of trials should be applauded, as they provide the evidence essential for clinical decision-making.
Obasogie’s rhetorical question “Is it ever ethical to ask the most vulnerable members of our society to give their bodies to science?” is at best patriarchal. Such an attitude has left the most needy in society, including the young and the old, bereft of clinical trial evidence. As a result, physicians are left to treat many patients based on little or no information on how their interventions will perform.
From Tony Grace, Canterbury, Kent, UK
I find Obasogie’s decision to link the human rights atrocities of the second world war to current practices in clinical trials objectionable. It seems to me an unsuitable attempt to introduce an emotional tone to the piece.
He goes on to discuss the trial by Pfizer in Nigeria of “an experimental antibiotic on children, leading to 11 deaths”. His phrasing suggests a causal relationship between the antibiotic and the deaths, but I am unaware of any evidence to support such an implication. Indeed, more children might have died if Pfizer had not intervened.
With stringent safeguards, independent overview and strong sanctions in place against those who fail to meet the rights of other human beings, it is ethical to ask vulnerable members of society to give their bodies to science. Many such people experience life-saving therapies during clinical trials which, unfortunately, may otherwise be unavailable to them.
From Mark Nelson, Chair, Discipline of General Practice, University of Tasmania School of Medicine, Hobart, Tasmania, Australia
Robot autonomy
The idea that robots do only what their designers intend, as David Flint’s letter assumes, is outdated (29 January, p 25). Even in the 1960s, when developing the GEORGE operating system, we sometimes tested what happened in certain circumstances and left things as they were if the results seemed reasonable, even if they hadn’t been designed that way.
Within this century, robots might become so complex that we need to start treating them like humans. In the next century, they may take this decision out of our hands. Would it be bad for the world to be run by the products of our brains, rather than those of our loins?
The future, now
Reading your editorial about futurology (25 December 2010, p 5) reminded me of a course I took in 1970 while I was a postdoctoral fellow at the University of California. The theme was “California in 2000 AD”, and speakers gave presentations on topics as diverse as hydrology, farming, urban planning, forestry and economics.
I have been amazed at how accurate their forecasts were. The prediction of a world population for the year 2000 of 6 billion, increasing at a billion per decade, proved close to the mark. More worrying was the prediction of a population crash when we reached 9 billion in the middle of this century.
Despite the changes in climate and loss of biodiversity that we are seeing, our political leaders seem unable to bring about the necessary changes in how we treat our planet. Watch the world news on TV and you will see the future: it is Haiti.
Selfish scientists?
I must take issue with Sebastian Hayes’s assertion that scientists take it for granted that their work should be funded regardless of its benefits to society at large (8 January, p 24).
To support his case he cites the failure of scientific job adverts to mention any benefit to humanity of the work in question. I would challenge this argument, as such adverts are attempting to attract people who have already chosen to work in science. Self-interest may guide a scientist’s career path when they are looking for a job, but it is not what brings people to science in the first place. If this were the only motivation, wouldn’t they all have become lawyers and accountants?
Hayes also proposes setting up workshops at which scientists answer questions from the public “where ordinary people can challenge researchers to justify the apparent absurdities of quantum mechanics and the theory of transfinite ordinals”. Given that funding available for science is limited, would this be a good use of a researcher’s time?
Events at which scientists share their research with a lay audience would be a more valuable use for a science workshop than the one Hayes proposes.
Hearty eaters
You report a study which shows that the consumption of fruit is linked to a reduction in the incidence of heart disease, concluding that perhaps people should be encouraged to increase their intake (22 January, p 7). However, just because people who eat more fruit are healthier, it does not mean that overall health can be improved by promoting the consumption of fruit. It could be that people who eat a lot of fruit are intrinsically different to those who don’t.
In fact, a report by the Cochrane Collaboration entitled “Multiple risk factor interventions for primary prevention of coronary heart disease” finds that in reality education programmes and healthy-eating campaigns have “little or no impact on the risk of coronary heart disease mortality or morbidity”, and that “the continued enthusiasm for health promotion practices given the failure of these community intervention trials is curious, especially given the huge resources which have been put into them.”
Near-death wish
In your interview with neuropsychologist Kevin Nelson (25 December 2010, p 80), he omitted one scenario in which near-death experiences (NDEs) can occur: during temporal lobe epileptic seizures. He went on to suggest that he would like to have an NDE.
I suffered a severe case of adult onset drug-resistant temporal lobe epilepsy, which ultimately required a partial temporal lobectomy. Based on my experiences, I would like to warn Nelson to be careful what he wishes for.
Dear beer
Petra Meier states that generally “alcohol has become steadily cheaper”, and suggests that the price of alcohol in pubs and bars has increased only slightly in real terms over the past 20 years (29 January, p 22). I have heard this a lot recently, though rarely supported by any convincing evidence.
My experience shows the opposite. In 1972, a pint of beer in a London pub cost 10 pence. A similar pint now costs 拢3.20, which is 32 times as much. By way of comparison, my salary in 1972 was 拢4000 and is now 拢52,000. That represents a 13-fold increase. One has clearly increased by far more than inflation.
Meteorite mystery
There is some debate over the object that fell from the sky onto a cricket match in Sussex, UK, in July 2010. It was described as a meteorite in the review of Ted Nield’s book Incoming! (22 January, p 47), but did it in fact fall from space?
An online report in The Telegraph dated suggests, less exotically, that the object probably fell from the undercarriage of a passing plane.
The vampire virus
Rabies would make an interesting addition to Paul Collins’s excellent piece on the basis for belief in vampires (29 January, p 40).
In the legends, those bitten by a vampire often became vampires themselves. It was undoubtedly the prevalence of diseases such as tuberculosis and syphilis in the late 19th century that supported the idea of a contagious spread of vampirism.
More recently, the Spanish neurologist Juan G贸mez-Alonso, inspired by a Dracula movie, suggested a link with rabies. Since the disease has circulated in Europe since the 18th century and is spread by bites from infected animals, he thinks it could have been behind the great surge in vampire tales.
The disease causes a number of bizarre behavioural changes, some of which are not unlike those a vampire is supposed to display. What’s more, the vampire bat, no doubt the inspiration for the host of stories in which vampires can transform into these animals, is one of the most significant transmitters of rabies in the US.
Artificial sanity
Anil Ananthaswamy’s exploration of artificial intelligence failed to consider what might happen when a computer gets a mind of its own (29 January, p 28). If AI reaches a point where it is conscious, what will it make of life, the universe and everything?
AI, if not evolved by natural selection, might not be able to understand life. Our selection-tested neurology helps keep us sane; will AI of the future have some form of protective filtering of its own ideas? Without it, what machines say could be hard to understand and maybe even harder to accept.
Tau good to be true
I applaud Michael Hartl’s efforts to promote tau (which is 2 pi, or 6.28318…) as the definitive circle constant (8 January, p 23).
He advises that we use the necessary factor of 2 when converting between tau and pi, which seems straightforward enough. I do wonder, though, how many Mars probes may be lost during the inevitable transition period.