The right to health freedom is primarily an ethical issue. But the uncertainty and unreliability of much medical “knowledge” (as argued in the book reviewed in the passages quoted below) seems to strengthen the case for patient self-determination.
(p. A15) The largest repositories of biomedical research in the U.S. and Europe, PubMed and Europe PMC, contain 84 million articles between them, and add a million more each year. According to recent estimates, up to 90% of those papers—75 million total—contain information that’s either misleading, wrong or completely fabricated.
Over the past 20 years, certain branches of science have endured a so-called reproducibility crisis, in which countless papers have been exposed as shoddy if not bogus. Sometimes these revelations are merely embarrassing, but in biomedical research, incorrect publications can cost lives as doctors and drugmakers rely on them to treat patients.
In “Unreliable: Bias, Fraud, and the Reproducibility Crisis in Biomedical Research,” Csaba Szabo—a physician with doctorates in physiology and pharmacology—dissects the ways he’s seen research go wrong in his 30 years in academia and industry: data manipulation, poor experimental design, statistical errors and more.
. . .
The biggest problem, however, lies with scientists who strive to do good work but feel pressured to cut corners. Scientists cannot work without grant money, but of the 70,000 applications the National Institutes of Health receive each year, only 20% get funded. Leading journals reject up to 99% of papers submitted, and only one in 200 doctoral graduates ever becomes a full professor. Even with tenure, professors can suffer salary cuts or have their labs handed to higher-performing colleagues if they don’t keep pulling in cash. Some sadistic research professors even pit their graduate students against each other in “dogfights”—they run the same experiment, but only the first to get results publishes. No wonder researchers massage data or fudge images: Forget “publish or perish.” It’s “fib or forgo your career.”
. . .
Given this tsunami of mistakes, the author points out that cynical types have suggested we treat all biomedical research as fraudulent unless proved otherwise. The cost is staggering: The U.S. wastes tens of billions of dollars annually on useless research, shortening or even costing patient lives. Most scientists can’t even reproduce their own data half the time, and the number of papers retracted rose to 10,000 in 2023 from 500 in 2010.
. . .
Most importantly, Dr. Szabo calls for systematic changes in how science gets done.
. . .
Above all, he despises the broken status quo, where “everybody acts politely . . . keeps their mouths shut, and acts like the whole process is functioning perfectly well.”
For the full review see:
Sam Kean. “Bookshelf; Reaching For Results.” The Wall Street Journal (Tuesday, March 24, 2025): A15.
(Note: ellipses between paragraphs added; ellipsis internal to paragraph, in original.)
(Note: the online version of the review was updated March 24, 2025, and has the title “Bookshelf; ‘Unreliable’: Reaching for Results.”)
The book under review is:
Szabo, Csaba. Unreliable: Bias, Fraud, and the Reproducibility Crisis in Biomedical Research. New York: Columbia University Press, 2025.