A doctor who made some important discoveries had an idea about using infection to treat cancer. He didn't bother with the proper process, he just went and did it on three patients. 2 of them died about as quickly as they would have anyway. We don't know if they were in more pain or not. 1 of them lived for about a year, and that person's relative described that year as very low quality of life. It's possible that the treatment kept this person alive, in this awful condition, much longer than she would have lived without the treatment.

He did this because he thought he was doing the right thing. It's clear to most people that he wasn't doing the right thing, and after he was discovered all the investigators were very clear that he'd done the wrong thing.

That story is contrasted with a team who did the right thing: they noticed a plausible mechanism of action; they gathered evidence; they got permissions; they did animal studies.

I don't mind the length of the article, but I agree that it wandered around a bit.

In my reading there were three parts of the article:

Part I: Optimism. Is this a new curative treatment for a cancer with an extremely poor prognosis? We get to see Muizelaar's perspective on why he (presumably) thought he was doing the right thing.

Part II: The Fall. Deaths, lawsuits, the expose, resignations.

Part III: Resolution. Maybe there is some value in an alternative approach that focuses on mechanism and iterates towards human trials via animal studies. But also, maybe there is something to be said about Muizelaar's approach that our current medicolegal system isn't equipped to handle.

To me, the structure of the article helped to underscore that Muizelaar might have been right, which is key for using this article as a way to learn about science and rationality as opposed to solely for its object-level information. Just listing the facts almost certainly would not have been as useful for getting that point across.

I liked it. Much better than the simple "LET ME TELL Y'ALL ABOUT AN UNETHICAL DOCTOR" opening to an article.

I'm more frustrated that there wasn't a clear editorial take in the article. I'd like to have seen some research done by the journalist into what the correct ethics are in a situation like this. My feeling is that without the option to have euthanasia (should things get worse) you are promising a tiny tiny chance of a possible cure but a large chance of increased suffering too.

The tiny chance of 40 more years of life might be worth it but its crazy to try experimental treatments as a first roll of the dice!

If you like audio there's a BBC Radio Four programme called "Inside the Ethics Committee". They have a bunch of people with real world experience of medical ethics, and they take real events and walk through them, explaining what happens at each step.

http://www.bbc.co.uk/programmes/b007xbtd

It's a surprisingly tough listen. Here's one example of a child with a treatable brain tumour. He didn't like the treatment, and when he got another tumour he decided he didn't want treatment.

http://www.bbc.co.uk/programmes/b0643x61

I think it's available to people outside the UK.

> I'm more frustrated that there wasn't a clear editorial take in the article.

I'm glad there wasn't. I think the issues raised are difficult ones, with no simple, obvious resolution. Sometimes we're better off living with complexity and ambiguity.

It's not complex at all! The doctor did loads of immoral things and the article sympathised with him.

He even says that he wouldn't attend training because he knows best. After his treatment caused several patients to suffer more or die earlier.

Sometimes we are better off calling bad medical practice illegal and immoral rather than trying to say "whaaaaa it's complicated".

I don't think it's nearly that black-and-white. The doctor performed a procedure he would have wanted performed on himself in the same (exceedingly desperate) circumstances. He was careful to fully inform the patients of the risks. Above all, he had his patients' welfare at heart; he wasn't doing it for money or fame or even knowledge. What he did may have been illegal, but I don't agree that it was clearly immoral.

I think the build up is intended to put you in the heads of the doctors who thought they were onto something... to help us understand how such a thing can happen.

It also makes for a great narrative since you are cheering the doctors on because it seems like they are onto something big.

But, if you hate reading long articles then steer clear of the new yorker. It's kind of the opposite of Reader's Digest.