The bureaucracy around clinical trials is Chesterton's Fence: it was built on the harm done by sloppier trials and should not be pulled down without knowing why it went up.

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  Environmental permitting now causes more environmental harm than it prevents, because what it delays is the clean thing replacing the dirty one.

  Lowe says the bureaucracy around clinical trials is Chesterton fence: it was built on the harm done by sloppier practice, and the harm is why it is there. Handmer says environmental permitting now causes more environmental harm than it prevents, because what it delays is the clean thing replacing the dirty one. Two review regimes, the same argument shape, opposite verdicts — and neither man has looked at the other one field.

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• Better drug candidates do not shorten clinical trials, because a trial's duration is set by operational and regulatory friction rather than by how good the drug is. RTRuxandra Teslo28 Feb 2026similar wording
• A therapy is only shown to be more effective if it is compared against another treatment intended to help, not against a control nobody expected to work. SMScott D. Miller11 Sept 2024similar wording
• The hard part of drug discovery is knowing what to make - which target is worth drugging - not designing the molecule. ATAlex Telford23 Dec 2023similar wording
• Standardised manufacturing and documentation cannot be skipped when a drug is given to human beings, because the noise they remove is the noise that would otherwise swallow the answer. DLDerek Lowe1 May 2020similar wording
• Clinical trials cost what they do because they are complex, bureaucratic and reliant on highly skilled labour. ATAlex Telford23 Dec 2023similar wording

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