Rough Theory

Theory In The Rough

Placebo Defect

I’ve been invited to design a very rough draft for a course on Science and Public Policy over the next couple of weeks. It would be an elective course and, since the course won’t have been offered previously at this university, it is uncertain which students would attend – it might attract students from the sciences who would like to learn more about communicating to policy makers, or students from the social sciences and humanities who would like to learn more about science, or some combination of the two.

I’m looking forward to designing the course, and would appreciate any suggestions for topics and/or readings appropriate to undergraduate students in their second year or higher.

While I’m thinking about popular perceptions of science, I wanted to pass along this anecdote, from an Australian morning TV show – Channel Ten’s 9 a.m. with David and Kim.

The show was discussing the recent British clinical trial of TGN1412, an immunomodulator developed by TeGenero. The trial, organised by PAREXEL, recruited eight volunteers, of whom six received TGN1412, while the remaining two received a placebo. Although the drug had appeared safe in animal trials, including primate trials, all who received TGN1412 during the human trial rapidly became critically ill. The incident has sparked an intensive review of this clinical trial, as well as questions about the protocols for human clinical trials more generally.

On 23 March, Dr. David Ritchie had been invited to explain the trial to the morning show audience. After hearing Dr. Ritchie’s breakdown of the trial, host David Reyne was apparently confused why, given the life-threatening reactions experienced by six trial participants, the two participants who had received the placebo fared so well. As ABC’s MediaWatch reports:

David Reyne: Some of these guys were given a placebo.

Dr. David Ritchie: Correct

David Reyne: I don’t really understand what a placebo is, but it seems to have, to have saved them! And wouldn’t it make sense that every time a trial like this takes place, that there’s a placebo on hand.

@” Channel 10, 9am with David and Kim, 23rd March, 2006, quoted by MediaWatch

Dr. Ritchie does eventually set things right – you can check the transcript or the video to see how.

4 responses to “Placebo Defect

  1. Russ April 29, 2006 at 8:17 pm

    That David Reyne quote is gold.

    Interesting course idea. I’d spend at least a week discussing “what is science?” and “how is science done?” for which I recommend:
    Origins of Knowledge and Imagination Jacob Bronowski
    Ascent of Science Brian Silver

    they also have lots to say on ethics, the general public. For theory,
    Criticism and the Growth of Knowledge ed Lakatos and Musgrave

    is good, but very dense. You probably know of better.

    Historically, public health programs (inoculations/vaccinations, but also fitness/obesity) aren’t discussed much at RMIT. There is an interesting description of 16th century plague in Venice in
    Venice: A Documentary History ed Chambers and Pulman

    Also try
    Disease and History by Cartwright and Biddes
    Dark Continent by Mark Mazower

    The latter ties in public health and Eugenics if you wanted to go there.

    Nuclear development is also worthwhile.
    The Ascent of Man by Jacob Bronowski (again)
    is excellent, and a tv series as well. Also:
    Brighter than a Thousand Suns by Robert Jungk
    and the auto-biography of Eugene Wigner

    Richard Feynman is also good on lots of issues, but I forget which books he says what in.

    Nuclear power and Global Warming would follow from that, for a contemporary issue that will only get bigger. John Quiggin talks about a lot of modern issues quite a bit as well.

    Far too much… oh well.

  2. N Pepperell April 29, 2006 at 11:56 pm

    Thanks for this – and don’t hesitate to add others, if you think of them.

    To provide a bit more background: I proposed the concept for the course in a more general discussion about creating electives that could (1) appeal to an interdisciplinary mix of students and (2) link with contemporary issues. So I’ve made a commitment not to design the course for any specific disciplinary perspective, and to tie the course fairly closely to contemporary events and debates. Everything else is up for grabs…

    I agree with the idea of starting with the issue of what science is. I haven’t decided whether to get into any of the more academic epistemological debates about scientific knowledge (e.g., the Sokal hoax, etc.) – although I personally find these debates interesting, I suspect they’d just weigh down a course that has more interesting “everyday” controversies to discuss…

    I’m tossing around the idea of organising the course thematically – one controversy at a time, for example – as well as the idea of organising it around key skills (researching scientific topics outside your area of specialisation, critically evaluating the limits of research methodologies, critically reading popular presentations of scientific material, communicating scientific concepts to a “lay” audience, etc.).

    I’m also trying to decide how… er… controversial the controversies I cover should be – so, for example, most people can speak at relative emotional arms-length from, say, an ethics of cloning debate, but what about a debate on sociobiology and gender or race? In the US, abortion would be a highly charged issue, as would Intelligent Design – are they here?

    I’m not sure what background students will carry into the course – how good is general science knowledge and education? Will most students be carrying a basic familiarity with, say, Darwin and Mendel? With statistics? With environmental science?

    And then there’s the issue of designing the assessment tasks and the readings such that students can still learn something, regardless of their disciplinary background coming in – so a physics student, for example, won’t need to zone out if we’re discussing Feynman, because the topic isn’t simply bringing social science students up to speed on physics 101. [Edited to note that I’m not suggesting that Feynman = Physics 101, but just pointing out that very clear writers like Feynman will be useful to nonspecialist students because they communicate scientific concepts very well, but that class discussion probably shouldn’t centre on “Oh! So *that’s* what X theory is all about!” – otherwise, it risks boring the students who are already conversant with the actual science… Or maybe class discussion *should* centre on the science – but with students who have scientific backgrounds taking the lead in explaining their own fields, and the social science humanities folks doing the same… Lots to think about…]

    I should note that, while all of these issues need to be resolved before the course is actually offered, they don’t necessarily need to be resolved in the next couple of weeks – the short-term object is to develop a clear enough course concept that it can be circulated to other people for comment and revision.

    Any comments or suggestions are much appreciated.

  3. Russ May 3, 2006 at 4:07 pm

    Nicole, I’ll start from the back, and work my disorganised way back in.

    You are right about Feynman and I should have been more specific. I was thinking of his semi-auto-biographical essays, rather than his teaching or research. Specifically, his works on “cargo-cult” science, and the way scientific and pseudo-scientific knowledge permeates society (and the role of the scientist in that milieu). Also the stuff he did on the Challenger investigation, cutting through the attempts to white-wash it.

    On scientific knowledge, I would prepare to be disappointed. You don’t have to do science after year 9/10 in high school, although I suspect the sciencophobes would avoid a course like this (maybe not). But you’ll need to, if not go over, at least put in the readings (which are never done) the basic concepts. This is where I think the value in historical narratives are. The science students might know Darwinism, but they won’t necessarily know the controversial history, so while the non-scientists are introduced to the scientific theories, the scientists are introduced to the history. Bronowski is particularly good for this, he always brings the history through to something current (well, current as of 1974).

    Silver will often discuss how such and such a scientific theory changed its contemporaries’ viewpoints. But I am probably showing my bias here towards theoretical and historical approaches: not what you ask, but how you ask it. Using science as a metaphor for social science research and vice-versa are fascinating, but possibly not what you had in mind.

    Australian politics is very pragmatic. Neither abortion nor intelligent design are highly controversial; a few people excepted. Race and gender are not talked about, rather than not controversial, so it might be a good debate, or people might not say anything in order to avoid offense.

    Perhaps you could design each weekly topic as an esoteric triplet: a basic scientific concept (and its development), a contemporary controversy it relates to, and an epistemological question/key skill?

  4. N Pepperell May 4, 2006 at 5:20 pm

    I like the triptych concept for readings and assignments – interrelated readings and tasks each week that provide the potential to approach each topic from the aspect of basic science, contemporary controversy, and epistemological issue/critical skill. This structure would also lend itself logically to an assessment structure where each student must do at least one assessment task related to each… er… panel in the triptych (not sure if I should have gotten that metaphor started…), but has the flexibility to choose which week they tackle a particular topic.

    I’d also like to vary the types of assessment tasks available, so that the course is more than “all essays, all the time”. I’ve seen some lovely critical websites put together as class projects, where the students collaborate, for example, to investigate the weaknesses of specific works. I like the concept, but am a bit leery about whether such an assignment might predetermine the conclusions students feel they must reach. But there should be some room for improvisation around the concept. I’ll have to think about it more…

    Thanks again for the recommendations – keep ’em coming, if you think of anything more.

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