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THE RIGHT TO TRY

HOW THE FEDERAL GOVERNMENT IS PREVENTING AMERICANS FROM GETTING THE LIFE-SAVING TREATMENTS THEY NEED

High-quality advocacy certain to stir debate.

The president and CEO of the Goldwater Institute makes a convincing case that the slow pace of the Federal Drug Administration's development and approval process for new medications is needlessly costing lives.

Throughout this forceful book, Olsen cites troubling statistics that underscore the depth of what she claims is a worsening problem. “The FDA,” she writes, “takes as long as 15 years to bring a new medicine to market and Americans are now waiting 60 percent longer for the FDA to approve life-saving medical devices—such as stents and valves—than they did just seven years ago.” This is particularly disturbing in the case of patients with serious illnesses who are denied access to promising new treatments. According to the author, one cause of the problem is asymmetry in the approval process. The FDA is incentivized to be overcautious. If someone dies after undergoing a new treatment approved by the agency, there is a scandal; however, there is insufficient attention paid to deaths attributable to delayed approval. “Instead of speeding medical innovation,” writes Olsen, “the FDA is slowing it down—demanding more data, more tests, and more procedures on more subjects before it will approve a drug.” In some cases, of course, more data and more tests are warranted. But though “American patients used to be the first to benefit from their country's enormous investments in basic medical research,” that is no longer the case. The author presents case histories of patients fortunate enough to be enrolled in FDA-approved trials, many of whom experienced remarkable cures. For terminally ill patients, the odds that an experimental drug will help, though as low as 20 percent, may still be attractive. Olsen’s organization is leading a bipartisan campaign to pass Right to Try legislation allowing patients and their doctors to bypass FDA regulations in deciding whether or not to try experimental treatments and for drug companies to make them available on a compassionate basis.

High-quality advocacy certain to stir debate.

Pub Date: Nov. 10, 2015

ISBN: 978-0-06-240752-8

Page Count: 304

Publisher: Harper/HarperCollins

Review Posted Online: Sept. 2, 2015

Kirkus Reviews Issue: Sept. 15, 2015

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WHEN BREATH BECOMES AIR

A moving meditation on mortality by a gifted writer whose dual perspectives of physician and patient provide a singular...

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A neurosurgeon with a passion for literature tragically finds his perfect subject after his diagnosis of terminal lung cancer.

Writing isn’t brain surgery, but it’s rare when someone adept at the latter is also so accomplished at the former. Searching for meaning and purpose in his life, Kalanithi pursued a doctorate in literature and had felt certain that he wouldn’t enter the field of medicine, in which his father and other members of his family excelled. “But I couldn’t let go of the question,” he writes, after realizing that his goals “didn’t quite fit in an English department.” “Where did biology, morality, literature and philosophy intersect?” So he decided to set aside his doctoral dissertation and belatedly prepare for medical school, which “would allow me a chance to find answers that are not in books, to find a different sort of sublime, to forge relationships with the suffering, and to keep following the question of what makes human life meaningful, even in the face of death and decay.” The author’s empathy undoubtedly made him an exceptional doctor, and the precision of his prose—as well as the moral purpose underscoring it—suggests that he could have written a good book on any subject he chose. Part of what makes this book so essential is the fact that it was written under a death sentence following the diagnosis that upended his life, just as he was preparing to end his residency and attract offers at the top of his profession. Kalanithi learned he might have 10 years to live or perhaps five. Should he return to neurosurgery (he could and did), or should he write (he also did)? Should he and his wife have a baby? They did, eight months before he died, which was less than two years after the original diagnosis. “The fact of death is unsettling,” he understates. “Yet there is no other way to live.”

A moving meditation on mortality by a gifted writer whose dual perspectives of physician and patient provide a singular clarity.

Pub Date: Jan. 19, 2016

ISBN: 978-0-8129-8840-6

Page Count: 248

Publisher: Random House

Review Posted Online: Sept. 29, 2015

Kirkus Reviews Issue: Oct. 15, 2015

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GOOD ECONOMICS FOR HARD TIMES

Occasionally wonky but overall a good case for how the dismal science can make the world less—well, dismal.

“Quality of life means more than just consumption”: Two MIT economists urge that a smarter, more politically aware economics be brought to bear on social issues.

It’s no secret, write Banerjee and Duflo (co-authors: Poor Economics: A Radical Rethinking of the Way To Fight Global Poverty, 2011), that “we seem to have fallen on hard times.” Immigration, trade, inequality, and taxation problems present themselves daily, and they seem to be intractable. Economics can be put to use in figuring out these big-issue questions. Data can be adduced, for example, to answer the question of whether immigration tends to suppress wages. The answer: “There is no evidence low-skilled migration to rich countries drives wage and employment down for the natives.” In fact, it opens up opportunities for those natives by freeing them to look for better work. The problem becomes thornier when it comes to the matter of free trade; as the authors observe, “left-behind people live in left-behind places,” which explains why regional poverty descended on Appalachia when so many manufacturing jobs left for China in the age of globalism, leaving behind not just left-behind people but also people ripe for exploitation by nationalist politicians. The authors add, interestingly, that the same thing occurred in parts of Germany, Spain, and Norway that fell victim to the “China shock.” In what they call a “slightly technical aside,” they build a case for addressing trade issues not with trade wars but with consumption taxes: “It makes no sense to ask agricultural workers to lose their jobs just so steelworkers can keep theirs, which is what tariffs accomplish.” Policymakers might want to consider such counsel, especially when it is coupled with the observation that free trade benefits workers in poor countries but punishes workers in rich ones.

Occasionally wonky but overall a good case for how the dismal science can make the world less—well, dismal.

Pub Date: Nov. 12, 2019

ISBN: 978-1-61039-950-0

Page Count: 432

Publisher: PublicAffairs

Review Posted Online: Aug. 28, 2019

Kirkus Reviews Issue: Sept. 15, 2019

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