Listen to podcast with the author How do doctors decide whether their drugs, or other treatments, actually work? In practice this can be fiendishly difficult. Nowadays the gold standard is the randomised controlled trial (RCT). But the RCT is a recent invention, and the story of how it came to dominate therapeutic evaluation from the latter half of the twentieth century involves acrimony, confrontation, and manipulation of the powerful rhetoric of ‘control’. Control and the Therapeutic Trial examines the development of the RCT from the eclectic collection of methodologies available to practitioners in the early-twentieth century. In particular, it explores the British Medical Research Council’s (MRC) exploitation of the term ‘controlled’ to help establish its own ‘controlled trials’ as the gold standard for therapeutic evaluation, and, ultimately, the MRC itself as the proper authority to adjudicate on therapeutic efficacy. This rhetorical power still clings, and is exploited today. Control and the Therapeutic Trial will be of interest not only to historians of twentieth-century medicine and practising clinicians who take therapeutic decisions, but to anyone who seeks a broader insight into the forces that shaped, and control, the modern controlled trial.

In response to a request by President Barak Obama on November 24, 2010, the Presidential Commission for the Study of Bioethical Issues oversaw a thorough fact-finding investigation into the specifics of the U.S. Public Health Service-led studies in Guatemala involving the intentional exposure and infection of vulnerable populations. Following a nine-month intensive investigation, the Commission has concluded that the Guatemala experiments involved gross violations of ethics as judged against both the standards of today and the researchers' own understanding of applicable contemporaneous practices. It is the Commission's firm belief that many of the actions undertaken in Guatemala were especially egregious moral wrongs because many of the individuals involved held positions of public institutional responsibility. The best thing we can do as a country when faced with a dark chapter is to bring it to light. The Commission has worked hard to provide an unvarnished ethical analysis to both honor the victims and make sure events such as these never happen again.

Public health officials and organizations around the world remain on high alert because of increasing concerns about the prospect of an influenza pandemic, which many experts believe to be inevitable. Moreover, recent problems with the availability and strain-specificity of vaccine for annual flu epidemics in some countries and the rise of pandemic strains of avian flu in disparate geographic regions have alarmed experts about the world's ability to prevent or contain a human pandemic. The workshop summary, The Threat of Pandemic Influenza: Are We Ready? addresses these urgent concerns. The report describes what steps the United States and other countries have taken thus far to prepare for the next outbreak of "killer flu." It also looks at gaps in readiness, including hospitals' inability to absorb a surge of patients and many nations' incapacity to monitor and detect flu outbreaks. The report points to the need for international agreements to share flu vaccine and antiviral stockpiles to ensure that the 88 percent of nations that cannot manufacture or stockpile these products have access to them. It chronicles the toll of the H5N1 strain of avian flu currently circulating among poultry in many parts of Asia, which now accounts for the culling of millions of birds and the death of at least 50 persons. And it compares the costs of preparations with the costs of illness and death that could arise during an outbreak.

Scores of talented and dedicated people serve the forensic science community, performing vitally important work. However, they are often constrained by lack of adequate resources, sound policies, and national support. It is clear that change and advancements, both systematic and scientific, are needed in a number of forensic science disciplines to ensure the reliability of work, establish enforceable standards, and promote best practices with consistent application. Strengthening Forensic Science in the United States: A Path Forward provides a detailed plan for addressing these needs and suggests the creation of a new government entity, the National Institute of Forensic Science, to establish and enforce standards within the forensic science community. The benefits of improving and regulating the forensic science disciplines are clear: assisting law enforcement officials, enhancing homeland security, and reducing the risk of wrongful conviction and exoneration. Strengthening Forensic Science in the United States gives a full account of what is needed to advance the forensic science disciplines, including upgrading of systems and organizational structures, better training, widespread adoption of uniform and enforceable best practices, and mandatory certification and accreditation programs. While this book provides an essential call-to-action for congress and policy makers, it also serves as a vital tool for law enforcement agencies, criminal prosecutors and attorneys, and forensic science educators.

How liberal democracies in the late twentieth century have sought to resolve public concerns over charged issues in medicine and science. Ethics boards have become obligatory passage points in today’s medical science, and we forget how novel they really are. The use of humans in experiments is an age-old practice that records show goes back to at least the third century BC, and it has been popular as a practice since the early modern period. Yet in most countries around the world, hardly any formal checks and balances existed to govern the communal oversight of experiments involving human subjects until at least the 1960s. Ethics by Committee traces the rise of ethics boards for human experimentation in the second half of the twentieth century. Using the Netherlands as a case study, historian Noortje Jacobs shows how the authority of physicians to make decisions about clinical research in this period gave way in most developed nations to formal mechanisms of communal decision-making that served to regiment the behavior of individual researchers. This historically unprecedented change in scientific governance came out of the growing international wariness of medical research in the decades after World War II and was meant to solidify a new way of reasoning together in liberal democracies about medicine and science. But what reasoning together meant, and who was invited to participate, changed drastically over time. In detailing this history, Jacobs shows that research ethics committees were originally intended not only to make human experimentation more ethical but also to raise its epistemic quality and intensify the use of new clinical research methods. By examining complex negotiations over the appropriate governance of human subjects research, Ethics by Committee is an important contribution to our understanding of the randomized controlled trial and the history of research ethics and bioethics more generally.

This open access book provides the first critical history of the controversy over whether to cull wild badgers to control the spread of bovine tuberculosis (bTB) in British cattle. This question has plagued several professional generations of politicians, policymakers, experts and campaigners since the early 1970s. Questions of what is known, who knows, who cares, who to trust and what to do about this complex problem have been the source of scientific, policy, and increasingly vociferous public debate ever since. This book integrates contemporary history, science and technology studies, human-animal relations, and policy research to conduct a cross-cutting analysis. It explores the worldviews of those involved with animal health, disease ecology and badger protection between the 1970s and 1990s, before reintegrating them to investigate the recent public polarisation of the controversy. Finally it asks how we might move beyond the current impasse.

Female philanthropy was at the heart of transformative thinking about society and the role of individuals in the interwar period. In Britain, in the aftermath of the First World War, professionalization; the authority of the social sciences; mass democracy; internationalism; and new media sounded the future and, for many, the death knell of elite practices of benevolence. Eve Colpus tells a new story about a world in which female philanthropists reshaped personal models of charity for modern projects of social connectedness, and new forms of cultural and political encounter. Centering the stories of four remarkable British-born women - Evangeline Booth; Lettice Fisher; Emily Kinnaird; and Muriel Paget - Colpus recaptures the breadth of the social, cultural and political influence of women's philanthropy upon practices of social activism. Female Philanthropy in the Interwar World is not only a new history of women's civic agency in the interwar period, but also a study of how female philanthropists explored approaches to identification and cultural difference that emphasized friendship in relation to interwar modernity. Richly detailed, the book's perspective on women's social interventionism offers a new reading of the centrality of personal relationships to philanthropy that can inform alternative models of giving today.

“Uses [pneumonia] as a vehicle for examining the evolution of therapeutics in America between the ‘Golden Age of Microbiology’ and the ‘Age of Antibiotics.’”—Isis Focusing largely on the treatment of pneumonia in first half of the century with type-specific serotherapy, clinician-historian Scott H. Podolsky provides insight into the rise and clinical evaluation of therapeutic “specifics,” the contested domains of private practice and public health, and—as the treatment of pneumonia made the transition from serotherapy to chemotherapy and antibiotics—the tempo and mode of therapeutic change itself. Type-specific serotherapy, founded on the tenets of applied immunology, justified by controlled clinical trials, and grounded in a novel public ethos, was deemed revolutionary when it emerged to replace supportive therapeutics. With the advent of the even more revolutionary sulfa drugs and antibiotics, pneumonia ceased to be a public health concern and became instead an illness treated in individual patients by individual physicians. Podolsky describes the new therapeutics and the scientists and practitioners who developed and debated them. He finds that, rather than representing a barren era in anticipation of some unknown transformation to come, the first decades of the twentieth-century shaped the use of, and reliance upon, the therapeutic specific throughout the century and beyond. This intriguing study will interest historians of medicine and science, policymakers, and clinicians alike. “Podolsky’s scholarship is awesome, and his grasp of the philosophical and sociologic context of the issues considered make this an important work.” —New England Journal of Medicine “This thoroughly documented, carefully written book is a landmark analysis . . . It should be read by everyone who is involved in research and therapeutic development.” —JAMA

Veteran journalist Gina Kolata's Flu: The Story of the Great Influenza Pandemic of 1918 and the Search for the Virus That Caused It presents a fascinating look at true story of the world's deadliest disease. In 1918, the Great Flu Epidemic felled the young and healthy virtually overnight. An estimated forty million people died as the epidemic raged. Children were left orphaned and families were devastated. As many American soldiers were killed by the 1918 flu as were killed in battle during World War I. And no area of the globe was safe. Eskimos living in remote outposts in the frozen tundra were sickened and killed by the flu in such numbers that entire villages were wiped out. Scientists have recently rediscovered shards of the flu virus frozen in Alaska and preserved in scraps of tissue in a government warehouse. Gina Kolata, an acclaimed reporter for The New York Times, unravels the mystery of this lethal virus with the high drama of a great adventure story. Delving into the history of the flu and previous epidemics, detailing the science and the latest understanding of this mortal disease, Kolata addresses the prospects for a great epidemic recurring, and, most important, what can be done to prevent it.