Fewer than half of medical interventions are supported by scientific evidence. These essays examine the hopes that the new push for comparative effectiveness research will improve medical care, the fears that it could harm the doctor‐patient relationship, and the experiences of states and countries that already put it into practice.

Some years ago, Deborah Blum, a Pulitzer Prize–winning science journalist, nailed the divide between scientists who conduct research on animals in the hope of advancing medical knowledge and people who object to that work for being immoral and inhumane. They are “like two different nations, nations locked in a long, bitter, seemingly intractable political standoff,” she wrote in her 1994 book, The Monkey Wars. The two sides certainly have been like nations locked in a long, bitter standoff. That standoff has (...) seemed intractable. But when Blum talked to people on both sides, she found glimmers of hope—a few individuals willing to listen to one another and find common ground. “When they can be freely heard,” she concluded, “then we will have progressed to another place, beyond this time of hostilities.” Today, while we are not yet beyond hostilities, we have progressed to another place. (shrink)

Hastings Center Report, Volume 52, Issue 1, Page inside_front_cover-inside_front_cover, January/February 2022.

For more than eleven years, I worked with Dan Callahan as an editor, a liaison with journalists, and a sounding board for ideas. To Dan, every new writing project was a thrill, whether it was for the New Republic or a blog. He consumed a wide range of professional and scholarly literature, followed the news with the eye of a reporter, and called experts when he wanted to learn more about something he had read. The result was a volcanic bubbling (...) of story ideas. If he didn't turn them into articles or books, I sometimes had the feeling that he might burst. (shrink)

Bioethics in the blogosphere. There is important news, and then there is important news that grabs hold of people and gets them thinking and talking: “Did you see the piece on . . . ?” “What do you think?” “What would you do?” That kind of news often has to do with bioethics. The desire to capture diverse perspectives on bioethical issues of the day led The Hastings Center to launch Bioethics Forum nearly five years ago. Greg Kaebnick, editor of (...) the Hastings Center Report, conceived of it as an online adjunct to the Report. Commentaries that would take at least a month to work their way through the Report’s production cycle could be posted immediately on Bioethics Forum. And the Forum might broaden our .. (shrink)

At a time of fake news, hacks, leaks, and unverified reports, many people are unsure whom to believe. How can we communicate in ways that make individuals question their assumptions and learn? My colleagues at The Hastings Center and many journalists and scientists are grappling with this question and have, independently, reached the same first step: recognize that facts can't be fully understood without probing their connection to values. “Explaining the basics is important, of course, but we also need to (...) diversify our approach to the coverage of science—particularly as it intersects with the matrix of cultural, religious, social, and political values of our readers,” said an article in Undark, an online magazine of science journalism. An editorial in Nature called for scientists to engage directly with citizens in debates over climate change and genome editing, noting that “the ethical issues can be critically dependent on the science, for example, in understanding where the boundaries between non-heritable and heritable genome modifications might be.” We're here to help. (shrink)

We first got to know TEDMED, a partner of TED (known for its entertaining talks on important ideas), in November 2011, when Jay Walker, its ebullient curator and chairman, visited The Hastings Center to discuss our common interests. What took place was an energizing conversation with Hastings Center staff and several members of the center's board of directors about some of the most intractable health care problems. Jay sketched his vision of marshaling creative and motivated leaders from business, public policy, (...) and medicine to address them. He imagined these people drawing on their areas of expertise to make unforeseen connections—perhaps some insight from business would spark a new idea for combatting childhood obesity or eliminating medical errors. They would use their influence to put the best ideas into practice. Soon after, Walker's colleagues were back in touch with a plan for launching his movement: The Great Challenges of Health and Medicine program. (shrink)

Genetic research powered by social media has the potential for great benefit: to quickly and inexpensively gather the massive amounts of data that are essential for understanding the genetic basis of diseases. But what are the ethical soft spots or gaps? I invite readers to write commentaries on this question for the blog of the Hastings Center Report.

To get an idea of how personalized medicine could reshape patient care in the years ahead, one need only look at how it is beginning to reshape the care of patients with cancer. Cancer is where personalized medicine has gained its firmest foothold. The longstanding scattershot practice of prescribing the same drugs to virtually all patients with a particular type of cancer is giving way to a more selective approach in which genetic tests are run on tumor samples to identify (...) which patients are likely to benefit from which drugs, or to tell whether they need drugs at all. This shift holds the prospect of improving cancer care and the stewardship of costly cancer care resources. It has had its successes and failures .. (shrink)

Research on how genetics contribute to human behavior and achievement raises many bioethical questions. What are we to make, for example, of a study published last year that found that students with genetic variants associated with educational attainment (years of education) took more advanced math classes in ninth grade? Does this finding have implications for education practice? Should it? How so? Questions like these serve as reminders that genetic science has long been misused to draw conclusions about individuals and groups (...) of people, conclusions laced with racism and other biases. As research on human genomics ramps up, now is the time to ramp up science communication about what these studies do and, importantly, do not show. A new feature on The Hastings Center's website does just that. (shrink)