It is true that some off-label drug use is based on very unsettled science and has more risks. But medicine - and not just cancer care - involves lots of hard choices. And the more serious the disorder, often the more likely it is that for every right and wrong treatment choice there are many other practical decisions painted in shades of gray.
Interpretation
Medical decisions often involve difficult choices and uncertainties.
This quote highlights the complexity of medical decision-making, particularly in cases involving off-label drug use. It suggests that while there are established treatments, there are many scenarios where choices are not clear-cut, and decisions must be made amidst uncertainty and varying degrees of risk, reflecting the complexities of healthcare.
In practice
During a medical conference discussing treatment options for complex conditions.
Science offers the chance to cure debilitating and once-intractable disorders like hemophilia and sickle cell disease. But we need to make sure the ability to access these therapies, or the risk that someone can be locked out of them, doesn't widen gaps between the rich and poor.
In fast moving fields like cancer, where doctors tailor treatments based on evidence that's constantly evolving, two years can be an eternity of waiting to learn about important science. For some patients, that interval can be fatal.
We need to make sure that access to a curative drug doesn't become a yardstick by which poverty is eventually measured. Doing so requires a shared commitment between innovators and the insurance plans that are harder pressed to offer these advances to the poor.
The fundamental reason why carbon dioxide in the atmosphere is critically important to biology is that there is so little of it. A field of corn growing in full sunlight in the middle of the day uses up all the carbon dioxide within a meter of the ground in about five minutes. If the air were not constantly stirred by convection currents and winds, the corn would stop growing.
...while science gives us implements to use, science alone does not determine for what ends they will be employed. Radio is an amazing invention. Yet now that it is here, one suspects that Hitler never could have consolidated his totalitarian control over Germany without its use. One never can tell what hands will reach out to lay hold on scientific gifts, or to what employment they will be put. Ever the old barbarian emerges, destructively using the new civilization.
As agonizing a disease as cancer is, I do not think it can be said that our civilization is threatened by it. ... But a very plausible case can be made that our civilization is fundamentally threatened by the lack of adequate fertility control. Exponential increases of population will dominate any arithmetic increases, even those brought about by heroic technological initiatives, in the availability of food and resources, as Malthus long ago realized.
Now, a living organism is nothing but a wonderful machine endowed with the most marvellous properties and set going by means of the most complex and delicate mechanism.
A great deal of my work is just playing with equations and seeing what they give.
For many parts of Nature can neither be invented with sufficient subtlety, nor demonstrated with sufficient perspicuity, nor accommodated unto use with sufficient dexterity, without the aid and intervening of the mathematics, of which sort are perspective, music, astronomy, cosmography, architecture, engineery, and divers others.
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