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"Right To Try" New Experimental Medicine and the Value of Experts

Accepted submission by Anonymous Coward at 2016-06-30 21:28:50
Science

At what point should an experimental drug be made available for anyone to try it?
[...] “Right To Try” law [allows] a therapy to be prescribed after it’s passed Phase I and is under active investigation in Phase II. [...] Insurance companies are not required to pay for these, it should be noted, nor are drug companies required to offer access.

The big underlying question here is “Who gets to make the decisions?” Right-to-try advocates would say that the patients themselves should be making those calls (presumably with some advice from their physicians). Others would say no, we need an FDA, some sort of regulatory authority to make sure that the therapies people are choosing from are actually worth choosing. Another argument is that the underlying medical and clinical issues are complex enough to make some sort of expert review worthwhile, and that we can’t necessarily expect “informed consent” to always be informed enough under some of the more wide-open proposals.

[...] The Limits of Expertise

Past that, though, you run into the folks who aren’t even bothering to appeal to experts at all, because they simply don’t trust them much and don’t believe what they have to say. Here, too, we have gradations. If we’re talking about the Poincaré Conjecture, to pick an issue on one end of the scale, the only people that will be of much use while discussing the details of Grigori Pearlman’s proof of it will be those who have devoted serious time to the study of topology. No one who is not comfortable dropping the phrase “Riemannian manifold” into their conversational flow can really have a seat at that table. Even world-renowned prize-winning scientists from many other fields are not going to able to pull up a chair.

Dr. Lowe breaks these types of questions into “Matter for Experts”, “Just Plain Facts”, “Flat-Out Unknowable”, and “Matters of Opinion” and the relative value of expertise for each.

http://blogs.sciencemag.org/pipeline/archives/2016/06/30/expertology [sciencemag.org]

Background on "Right To Try" laws:
http://blogs.sciencemag.org/pipeline/archives/2014/06/10/right_to_try_here_we_go [sciencemag.org]


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