Go back to Part 1: Introduction or Part 2: Case Study – God’s Own Medicine

After describing the seven worst inventions in Pandora's Lab, Paul Offit offers seven observations. The book goes into much greater detail, referring back to some of the seven worst inventions and mentioning additional examples. I have extracted a statement that demonstrates the basic principle of each:

1. It’s all about the data.  Offit begins with a comment that confirms the point I have made in InfoMatters blogs, including the previous one on the collapse of the Low-Fat paradigm: “Truths emerge when studies performed by different scientists working in different environments using different methods find similar results. Ignoring these truths can have disastrous consequences.” Done properly and with enough time, reliable data should emerge. Too often, however, data is limited, skewed, and the testing to obtain it is rushed. Garbage in, garbage out! 
2. Everything has a price; the only question is how big. “The challenge is figuring out whether a particular technology is worth the price. And we shouldn’t grandfather in certain technologies just because they’re been around for decades, or even centuries. All technologies should be constantly evaluated.”
3. Beware the zeitgeist. “Three current technologies have been victims of the current culture: e-cigarettes, because no one likes the image of a teenager smoking, even if it’s not actually smoke; GMOs, because the technology smacks of hubris, our attempt to alter the natural order; and bisphenol A (BPA), because it is a chemical resin that can leach out of plastic baby bottles. All three technologies have been the victims of scientific studies purporting harm. And all three have suffered at the hands of the media. Negative press, however, shouldn’t blind us to the evidence” [which Offit goes on to explain is much more nuanced and requires careful analysis).
4. Beware the quick fix. Extending his discussion of lobotomy being accepted at a time of desperate need in the climate of psychiatric care, Offit uses the example of autism to show that a similar scenario could happen today, with great risk to those being treated. “Desperate to do something, anything, to cure the incurable, we continue to punish the afflicted.”
5. The dose makes the poison. “When Rachel Carson wrote Silent Spring, she correctly predicted that man-made activities could destroy the environment. Thanks to Rachel Carson we are now far more attentive to our impact on the plant. Unfortunately, Carson also gave birth to the notion of zero tolerance—the assumption that any substance found harmful at any concentration or dosage should be banned absolutely.” Offit then goes on in detail to refute this claim.
6. Be cautious about being cautious. “Rachel Carson taught us caution. Wouldn’t it make sense to ban DDT given that at the very least, it might cause harm to people. As we learned, removing it from use caused far more harm than good.”  Offit then uses cancer as an example of over-wrought caution (you’ll have to read the book to see how he develops this argument, which leads to the conclusion, “Our overzealous sense of caution has caused a lot of unnecessary fear, anxiety, and debilitating surgeries.”
7. Pay attention to the little man behind the curtain. “Today, it’s not hard to find people who give medical or scientific advice based on the Wizard of Oz effect. Health gurus all hope that their winning personalities will hide their lack of evidence. And they don’t like to be challenged. When little men behind curtains are reveaedl to be just little men behind curtains, they often cry foul. It wasn’t that their claims were wrong, they argue, it was that evil forces were conspiring to defeat them. . . . The minute that you hear researchers claim conspiracy, you should suspect that their hypotheses are built on sand. And although their this-is-what-happens-when-you-speak-truth-to-power lament is appealing, it doesn’t mean it’s right. As Norman Levitt, a mathematician and debunker of pseudoscience, famously said, ‘While Galileo was a rebel, not all rebels are Galileo’—no matter how hard they try to convince you that they are.”

Paul Offit tells a cautionary tale that deserves careful consideration.  Even when best practices are followed, unforeseen and unintended consequences can result. Even worse, we can be so driven to solve a problem that we do not consider that unintended consequences could offset or overwhelm whatever good may result. 

GO BACK to Part 1: Introduction or Part 2: Case Study – God’s Own Medicine