Imagine that you're a doctor, and you're presented with some cases of a new, nasty lurgy. So nasty that it kills about 8 out of ten people you see with it (you only see the serious cases). You're pretty desparate to find something that will cure it, or at least reduce the death rate, and you recall that Medicinal Compound was efficatious in a similar outbreak in the past. MC also has the advantages that it's cheap, its toxicity is known to be close to zero in the correct dose, and it has been widely used for years.
So you call up Pink Lilly Pharmaceuticals, and order a batch of Medicinal Compound, and try it out. And behold, out of the next ten patients that you see, only 3 die instead of 8. The question is: what do you do now?
There are many options available to you, of course, and you must realise that all you have to offer right now is "anecdotal evidence". If you are a normal human being, you will probably continue to use MC to see if your result is just a fluke. You might phone up some colleagues elsewhere in the country or in the world, to tell them about your results and find out if they also might have tried it, and with what outcome. Only if your conversations convince you that MC is inefficatious would you think about stopping using it, and then only maybe.
What you probably won't do is stop using Medicinal Compound until a randomised double-blind trial proves that it is efficatious (or not) in these cases. You might even question the morality of giving people a placebo in such a trial, given the success you have had with MC.
What you also wouldn't do is stop using Medicinal Compound while you scrabble around looking to find or develop a new, expensive treatment of unknown toxicity and side-effects to inflict on all of your patients. Why on Earth would you do that?
What you also wouldn't do is organise a limited trial in which you give potentially toxic overdoses of MC to people who are seriously ill with the lurgy, at a stage of the disease when MC is known not to work, find out that they die, and then proclaim that MC doesn't work.
Well, that would be fine unless a man who is not a politician said "Maybe we should look into that." Referring to Medicinal Compound, whereupon the rest of the political establishment had a complete meltdown and forbade the use of any type of medicinal compound except what their friends were able to lash up from Monkey viruses.
ReplyDeleteSo people continued to die until the disease burned itself out, as fatal diseases are wont to do.