Category: Public Choice

Long Waits for Italian Cabs Due to Regulations Limiting More Cabs and Ride-Sharing

(p. A4) Returning to Rome from Naples one Monday afternoon in June [2023], a train trip that takes just over an hour, Daniele Renzoni said that he and his wife waited for more than an hour and a half at Termini station for a cab under a blazing sun.

“Just image a long line of grumbling, frustrated people, complaining, cursing. Hot day, angry tourists, there’s not much else to say,” said Mr. Renzoni, who is retired. “Taxi drivers will tell you there’s too much traffic, too many requests, too much everything, but the fact is, the customer pays.”

The situation is “a disgrace to Italy,” said Furio Truzzi, president of the consumer rights group Assoutenti, one of several associations that protested the shortage.

. . .

Thanks to the taxi lobby, ride-sharing services are almost nonexistent in Italy, where Uber is the only platform in use, with many restrictions.

The government lost an opportunity for real change, said Andrea Giuricin, a transportation economist at a research center at the University of Milan Bicocca. He said the best way to meet consumer needs would be to increase the number of licenses for Italy’s chauffeur services, known as N.C.C., which work with Uber.

“It’s very difficult in Italy” because “there isn’t a culture of liberalization in general,” creating little opportunity for competition, said Professor Giuricin. Taxis “are a small but powerful lobby” that easily influences politics, “which is very weak” in Italy, he said.

Angela Stefania Bergantino, a professor of transportation economics at the University of Bari, pointed out that previous governments had tried to open up the taxi market. But they failed.

“The problem is that taxis are regulated by municipal governments, which can find themselves captive in the sense that it is difficult for City Hall to implement policies that the cab lobby doesn’t like,” she said. “These are lobbies that have effective strike tools,” like wildcat strikes or traffic blockages that can paralyze entire cities, she said.

. . .

Above all, though licenses are issued by the city, they can then be sold by the drivers, for sums that can reach 250,000 euros, or about $276,000, depending on the city — a retirement nest egg for many. With an influx of new licenses, the value of an existing license would depreciate.

City administrators fear cabbies could revolt and strike if the status quo changes. “If I decide to issue new licenses,” said Eugenio Patanè, Rome’s city councilor in charge of transportation, “I’m going to find 1,000 taxis blocking traffic in Piazza Venezia,” the downtown Rome square that taxi drivers habitually clog while protesting.

For the full story, see:

Elisabetta Povoledo. “Getting a Cab in Italy Is Hard. But Remedying That Isn’t Easy.” The New York Times (Friday, August 11, 2023): A4.

(Note: ellipses, and bracketed year, added.)

(Note: the online version of the story has the date Aug. 10, 2023, and has the title “Getting a Taxi in Italy Is Too Hard. Fixing That Is Not Easy.”)

“Persistent Plucky Outsiders” Innovate a Better Way to Stop Bleeding

(p. 20) Charles Barber’s “In the Blood” treats a consequential topic, and contains moments of real insight, drama and humor.

. . .

Though hemorrhage is a leading cause of death in both war and peacetime, we learn, the techniques for stopping it haven’t improved significantly for millenniums. Barber explores the mysteries of the “coagulation cascade” — during which diverse proteins activate in intricately choreographed sequence to facilitate clotting — as well as the “lethal triad” of hypothermia, acidosis and coagulopathy (impaired clotting) that can send the body into shock.

We watch a surgeon at a Navy hospital in Bethesda slit the femoral arteries of a herd of 700-pound pigs, then apply different hemostatic agents to the spurting wounds, to see which substance stops the bleeding best. Most products, backed by biotech and medical companies, fail: The poor beasts bleed out. But zeolite, a simple mineral with hitherto unknown hemostatic properties, saves their bacon every time.

Barber’s earlier books feature persistent, plucky outsiders who strive to change the world, and he finds two more likely subjects in the men who brought zeolite’s lifesaving properties to light. Frank Hursey is the brilliant, nerdy engineer who discovers that this cheap, highly porous mineral, used by industry to absorb radiation, chemicals and bad odors, also happens to accelerate clotting, by mopping up water in the blood and thereby concentrating its coagulation agents. (Later Hursey finds that another inexpensive mineral, kaolin, works even better.)

Barely anyone pays attention to Hursey’s discovery until he partners with Bart Gullong, a down-on-his-luck salesman who rebrands Hursey’s invention “QuikClot” and persuades a military scientist to try it out on people. Hursey and Gullong are soon befriended by iconoclasts within the armed forces medical establishment, more of Barber’s appealing, quirky, determined Davids, who together take on two of the biggest Goliaths around: the military-industrial complex and Big Pharma.

For the full review, see:

Tom Mueller. “The Home Front.” The New York Times (Sunday, Aug. 20, 2023): 20.

(Note: ellipsis added.)

(Note: the online version of the review has the date July 26, 2023, and has the title “A Fight to Save Soldiers, From the Lab to the Battlefield.”)

The book under review is:

Barber, Charles. In the Blood: How Two Outsiders Solved a Centuries-Old Medical Mystery and Took on the Us Army. New York: Grand Central Publishing, 2023.

To Cut Out Costs of Car Dealership Middlemen, Tesla Is Selling Direct from Indian Reservation Showrooms

(p. D6) Tesla is ramping up efforts to open showrooms on tribal lands where it can sell directly to consumers, circumventing laws in states that bar vehicle manufacturers from also being retailers in favor of the dealership model.

Mohegan Sun, a casino and entertainment complex in Connecticut owned by the federally recognized Mohegan Tribe, recently announced that the California-based electric automaker will open a showroom with a sales and delivery center this fall on its sovereign property, where the state’s law doesn’t apply.

The news comes after another new Tesla showroom was announced in June, set to open in 2025 on lands of the Oneida Indian Nation in upstate New York.

“I think it was a move that made complete sense,” said Lori Brown, executive director of the Connecticut League of Conservation Voters, which lobbied for years to change Connecticut’s law.

. . .

Brown noted that lawmakers with car dealerships that are active in their districts, no matter their political affiliation, traditionally opposed bills allowing direct-to-consumer sales.

. . .

Over the years in numerous states, Tesla sought and was denied dealership licenses, pushed for law changes and challenged decisions in courts.

. . .

Tesla opened its first store as well as a repair shop on Native American land in 2021 in New Mexico. The facility, in Nambé Pueblo, north of Santa Fe, marked the first time the company partnered with a tribe to get around state laws, though the idea had been in the works for years.

For the full story, see:

SUSAN HAIGH, Associated Press. “Tesla to Open Showrooms on Tribal Lands to Circumvent Laws.” Omaha World-Herald (Sunday, Aug. 13, 2023): D6.

(Note: ellipses added.)

(Note: the online version of the story has the date Aug. 5, 2023, and has the title “Automaker Tesla is opening more showrooms on tribal lands to avoid state laws barring direct sales.”)

“FDR’s Policies Laid the Foundations for Generations of Hardship” for Black Americans

(p. A13) Just past the midway point of “Black Americans, Civil Rights, and the Roosevelts”—a powerful and powerfully disturbing exhibition at the Franklin D. Roosevelt Presidential Library and Museum—you can pick up a headset and listen to parts of a secretly recorded White House meeting on Sept. 27, 1940 (a transcript is also provided).

. . .

. . ., FDR nonchalantly settles into condescension and caricature. He emphasizes his appreciation of black servicemen, recalling “my colored messenger in the Navy Department”: “I gave him to Louis Howe, who was terribly fond of him.” And he promises to support opportunities for Negroes. In the Navy, he suggests, they could play in bands: “There’s no reason why we shouldn’t have a colored band on some of these ships, because they’re darn good at it.”

It is a shock to come upon these words. They even raise a question of just how much the administration’s sluggishness in dealing with racial issues was due to the power of Southern Democrats.

. . .

. . . the exhibition argues . . . that FDR’s policies laid the foundations for generations of hardship. The Social Security Act of 1935, for example, is criticized for not including “farm and domestic workers, who were disproportionately Black. This kept nearly two-thirds of Black workers out of the program”—in part, the text suggests, because of Southern Democrats’ racist influence. The exhibition also argues that the “redlining” of neighborhoods by Roosevelt’s Home Owners’ Loan Corporation, which mapped out areas with the highest probability of mortgage defaults, harmed the very neighborhoods where most blacks lived, with an effect lasting generations.

Racism, of course, should not be dismissed as a factor, but these are complicated issues, and much literature challenges any sweeping assertions. Did racism play an important role in excluding farm workers and domestics from Social Security, as the exhibition ends up suggesting? A 2010 Social Security Administration paper argues otherwise, noting that 74% of all excluded workers in those categories were white. Moreover, the act also excluded the self-employed, crews of ships, and employees of nonprofit religious and educational institutions. A 1997 paper in Political Science Quarterly argued that such initial exclusions were likely due to difficulties in how taxes and payrolls were handled, adding too many challenges to the administration of a new social program. Studies of redlining have also led to questions about its racial origins and effects. Redlined areas housed large proportions of a city’s black residents, but about three-quarters of the inhabitants were white. And as a 2021 paper from the National Bureau of Economic Research suggests, the maps were reflections of economic conditions, not racial demarcations, and “had little effect” on the distribution of federal mortgage activity.

For the full exhibition review, see:

Edward Rothstein. “Black Americans and the New Deal.” The Wall Street Journal (Thursday, Aug. 24, 2023): A13.

(Note: ellipses added.)

(Note: the online version of the exhibition review has the date August 23, 2023, and has the title “Black Americans, Civil Rights, and the Roosevelts’ Review: A New Look at the New Deal Era.”)

The 2021 National Bureau of Economic Research (NBER) paper mentioned above was published online in 2022 (in advance of print publication):

Fishback, Price, Jonathan Rose, Ken Snowden, and Thomas Storrs. “New Evidence on Redlining by Federal Housing Programs in the 1930s.” Journal of Urban Economics (online on May 11, 2022).

Crisis in Wind Industry Due to Inflation, Regulatory, and Grid Connection Hurdles

(p. B5) The wind business, viewed by governments as key to meeting climate targets and boosting electricity supplies, is facing a dangerous market squall.

After months of warnings about rising prices and logistical hiccups, developers and would-be buyers of wind power are scrapping contracts, putting off projects and postponing investment decisions. The setbacks are piling up for both onshore and offshore projects, but the latter’s problems are more acute.

In recent weeks, at least 10 offshore projects totaling around $33 billion in planned spending have been delayed or otherwise hit the doldrums across the U.S. and Europe.

“At the moment, we are seeing the industry’s first crisis,” said Anders Opedal, chief executive of Equinor, in an interview.

. . .

The holdup of projects that could generate 11.7 gigawatts—enough to power roughly all Texas households and then some—likely pushes 2030 offshore wind targets out of reach for the Biden administration and European governments.

. . .

(p. B11) The list of woes is long: inflation, supply-chain backlogs, rising interest rates, long permit and grid connection timelines. The increasing pace of the energy transition has created a loop of escalating costs.

For the full story, see:

Mari Novik and Jennifer Hiller. “Wind Power Stumbles as Problems Mount.” The Wall Street Journal (Tuesday, Aug. 8, 2023): B5 & B11.

(Note: ellipses added.)

(Note: the online version of the story was updated Aug. 7, 2023, and has the title “Wind Industry in Crisis as Problems Mount. The online version says that the title of the print version is “Wind Power Stumbles as Cost, Logistical Problems Mount.” But my print version of the national edition had the shorter title “Wind Power Stumbles as Problems Mount.”)

Foundations with an End Date May Honor the Donor’s Intent

(p. C6) This year, the William E. Simon Foundation is closing its doors, or “sunsetting,” in the parlance of modern philanthropy. Since it was founded in 1967 by former Treasury Secretary William E. Simon and his wife Carol, the foundation has given away almost $300 million to the causes that mattered to them—faith, family and education.

. . .

Traditionally, sunsetting a foundation has appealed to more conservative donors. Bill Simon, Jr., who manages the Simon Foundation along with his six siblings, says that his late father set a closing date because he had seen “foundations that seemed to veer off of their donor’s intent.” Simon recalls: “Dad trusted his own seven children to know where he would have put his money…But as much as he loved his grandchildren, he did not know them.”

Indeed, Henry Ford II resigned from the Ford Foundation’s board in 1977, writing that its hostility to capitalism had thrown it off course: “Perhaps it is time for the trustees and staff to examine the question of our obligations to our economic system and to consider how the foundation, as one of the system’s most prominent offspring, might act most wisely to strengthen and improve its progenitor.”

For the full commentary, see:

Naomi Schaefer Riley. “Philanthropists Discover the Value of ‘Sunsetting’.” The Wall Street Journal (Saturday, Aug. 5, 2023): C6.

(Note: ellipsis added.)

(Note: the online version of the commentary has the date August 3, 2023, and has the same title as the print version.)

The Elite Are Politically Progressive as a Way to Reduce Their Guilt for Rejecting the Uneducated

David Brooks, the author of The New York Times column quoted below, views himself as an anti-Trump member of America’s elite educated class.

(p. A18) Donald Trump seems to get indicted on a weekly basis. Yet he is utterly dominating his Republican rivals in the polls, and he is tied with Joe Biden in the general election surveys. Trump’s poll numbers are stronger against Biden now than at any time in 2020.

What’s going on here? Why is this guy still politically viable, after all he’s done?

. . .

This story begins in the 1960s, when high school grads had to go off to fight in Vietnam but the children of the educated class got college deferments. It continues in the 1970s, when the authorities imposed busing on working-class areas in Boston but not on the upscale communities like Wellesley where they themselves lived.

The ideal that we’re all in this together was replaced with the reality that the educated class lives in a world up here and everybody else is forced into a world down there. Members of our class are always publicly speaking out for the marginalized, but somehow we always end up building systems that serve ourselves.

The most important of those systems is the modern meritocracy. We built an entire social order that sorts and excludes people on the basis of the quality that we possess most: academic achievement. Highly educated parents go to elite schools, marry each other, work at high-paying professional jobs and pour enormous resources into our children, who get into the same elite schools, marry each other and pass their exclusive class privileges down from generation to generation.

Daniel Markovits summarized years of research in his book “The Meritocracy Trap”: “Today, middle-class children lose out to the rich children at school, and middle-class adults lose out to elite graduates at work. Meritocracy blocks the middle class from opportunity. Then it blames those who lose a competition for income and status that, even when everyone plays by the rules, only the rich can win.”

. . .

Members of our class also segregate ourselves into a few booming metro areas: San Francisco, D.C., Austin and so on. In 2020, Biden won only 500 or so counties, but together they are responsible for 71 percent of the American economy. Trump won over 2,500 counties, responsible for only 29 percent. Once we find our cliques, we don’t get out much. In the book “Social Class in the 21st Century,” the sociologist Mike Savage and his co-researchers found that the members of the highly educated class tend to be the most insular, measured by how often we have contact with those who have jobs unlike our own.

. . .

Elite institutions have become so politically progressive in part because the people in them want to feel good about themselves as they take part in systems that exclude and reject.

For the full commentary, see:

David Brooks. “What if We’re the Bad Guys Here?” The New York Times (Friday, August 4, 2023): A18.

(Note: ellipses added.)

(Note: the online version of the commentary has the date Aug. 2, 2023, and has the same title as the print version.)

The books cited by Brooks in the passages quoted above are:

Markovits, Daniel. The Meritocracy Trap: How America’s Foundational Myth Feeds Inequality, Dismantles the Middle Class, and Devours the Elite. New York: Penguin Press, 2019.

Savage, Mike. Social Class in the 21st Century. London: Pelican Books, 2015.

Socialist Alexandria Ocasio-Cortez (AOC) Buys Foreign Sunscreens Not Approved by U.S. Government F.D.A.

(p. 2) After months of prompting, I have finally managed to help my husband form a daily sunscreen habit. Whenever I see traces of paper white cream in his dark beard, I think, We’re halfway there.

Hoping to avoid the white cast, heaviness and greasiness common in many sunscreen products available in U.S. drugstores, some Americans, including Representative Alexandria Ocasio-Cortez of New York, have taken matters into their own hands, opting for sunscreens manufactured abroad. In a recent interview, the congresswoman said she toggled between Bioré in the summer and Beauty of Joseon in the winter — two Asian brands that employ active ingredients not approved for use in the United States.

“The technology is very sophisticated,” Ms. Ocasio-Cortez said. “You don’t feel like you have a layer of sunscreen on, and it kind of just feels like you’re putting on a moisturizer in that sense, which makes it easier to use.”

While sunscreen is regulated as a cosmetic in major skin-care hubs like South Korea, Japan and the European Union, in the United States, it falls under the purview of the Food and Drug Administration. Any drug product marketed to American consumers must be approved by the F.D.A., and because sunscreen “makes a drug claim” — namely, that it can prevent sunburn, decrease the risk of skin cancer and mitigate early skin aging — the agency regulates it as an over-the-counter drug.

The last time the Food and Drug Administration approved new active ingredients for use in sunscreens was more than two decades ago, and at times it can feel as if the rest of the world has surpassed the United States in the development of new sunscreen formulations and protocols. Skin-care influencers on TikTok and Instagram are in a near-constant state of frenzy over exciting new products and innovations that are nowhere to be found on American shelves. Currently there are 14 sunscreen filters approved for use by the F.D.A. The European Union employs more than 30.

Frustrated by what seems to be a wealth of more exciting options for sun protection overseas, skin-care-conscious Americans have been quick to point the finger at the F.D.A. for the delay in approving new active ingredients.

For the full story, see:

Sandra E. Garcia. “U.S. Sunscreen Is Stuck in the ’90s.” The New York Times, SundayStyles Section (Sunday, August 13, 2023): 2.

(Note: the online version of the story has the date Aug. 12, 2023, and has the title “U.S. Sunscreen Is Stuck in the ’90s. Is This a Job for Congress?”)

Chinese Communists Suspend Release of Record High Youth Unemployment Rate

(p. B1) The Chinese government, facing an expected seventh consecutive monthly increase in youth unemployment, said Tuesday [Aug. 15, 2023] that it had instead suspended release of the information.

The unemployment rate among 16- to 24-year-olds in urban areas hit 21.3 percent, a record, in June and has risen every month this year. It was widely forecast by economists to have climbed further last month.

The decision to scrub a widely watched report could exacerbate the concerns expressed by investors and executives who say ever-tightening government control of information is making it harder to do business in China.

Fu Linghui, a spokesman of the National Bureau of Statistics, said at a news briefing that the government would stop making public employment information “for youth and other age groups.” He said the surveys that government researchers use to collect the data “need to be further improved and optimized.”

China’s youth unemployment rate has doubled in the last four years, a period of economic volatility induced by the “zero Covid” measures imposed by Beijing that left companies wary of hiring, interrupted education for many students, and made it hard to get the internships that had often led to job offers.

The announcement drew more than 140 million views on the Chinese social media site Weibo within a few hours. Many people (p. B3) commenting online, some turning to sarcasm, said they believed the government suspended the report to try to hide negative information. Others said they believed the public had the right to be informed.

. . .

Young people in China are facing a big gap between labor demand and supply. According to official data, 11.6 million students were expected to graduate college or university this year — the most ever and nearly one million more than last year. Future classes are expected to be even larger, while economic growth had started to slow even before the pandemic.

. . .

Even becoming an entry-level civil servant working for the government is harder these days. Last year, a record 2.6 million people applied to take the national civil service exam to compete for only 37,100 entry-level positions.

Xi Jinping, the country’s top leader, has called for young people to go to remote areas to find work — to “eat bitterness,” a Chinese expression that refers to enduring hardship.

For the full story, see:

Claire Fu. “China Scraps Jobs Report On the Young.” The New York Times (Wednsday, August 16 2023): B1 & B3.

(Note: ellipses, and bracketed date, added.)

(Note: the online version of the review has the date Aug. 15, 2023, and has the title “China Suspends Report on Youth Unemployment, Which Was at a Record High.”)

State College Budgets Balloon to Pay for Buildings, Sports, and Administrators

(p. A1) The nation’s best-known public universities have been on an unfettered spending spree. Over the past two decades, they erected new skylines comprising snazzy academic buildings and dorms. They poured money into big-time sports programs and hired layers of administrators.

Then they passed the bill along to students.

The University of Kentucky upgraded its campus to the tune of $805,000 a day for more than a decade. Its freshmen, who come from one of America’s poorest states, paid an average $18,693 to attend in 2021-22.

Pennsylvania State University spent so much money that it now has a budget crisis—even though it’s among the most expensive public universities in the U.S.

The University of Oklahoma hit students with some of the biggest tuition increases, while spending millions on projects including acquiring and renovating a 32,000-square-foot Italian monastery for its study-abroad program.

The spending is inextricably tied to the nation’s $1.6 trillion federal student debt crisis. Colleges have paid for their sprees in part by raising tuition prices, leaving many students with few options but to take on more debt. That means student loans served as easy financing for university projects.

“Students do not have the resources right now to continue to foot the bill for all of the things that the university wants to do,” said Crispin South, a 2023 Oklahoma graduate. “You can’t just continue to raise revenue by turning to students.”

It has long been clear to American families that the cost of college has gone up, even at public schools designed to be affordable for state residents. To get at the root cause, The Wall Street Journal examined financial statements since 2002 from 50 universities known as flagships, typically the oldest public school in each state, and adjusted for inflation.

. . .

(p. A9) Public university leaders often blame stingier state funding for the need to raise tuition revenue.

. . .

For every $1 lost in state support at those universities over the two decades, the median school increased tuition and fee revenue by nearly $2.40, more than covering the cuts, the Journal found.

. . .

Much of the increase in outlays showed up in the hiring process, for administrators, faculty, coaches and finance experts, the Journal’s analysis found. Salaries and benefits, which usually eat up more than half of operating budgets, rose by roughly 40% at the median flagship since 2002.

The University of Florida in 2022 had more than 50 employees with titles of director, associate director or assistant director of communications, roughly double the number it had in 2017. The school also employed more than 160 assistant, associate, executive and other types of deans last year, up from about 130 in 2017.

. . .

Though a handful of powerhouse sports departments pay for themselves, most can break even only with student fees and university subsidies. Across all flagships with available data, that additional funding totaled $632 million in 2022. That’s a jump of 27% from 12 years prior.

. . .

Research by James V. Koch, an economist who studies college spending and a former president at Old Dominion University in Virginia, found that public-university trustees approved 98% of the cost-increasing proposals they reviewed, often unanimously. In most states, he said, there hasn’t been anyone to say, “No, you can’t do that.”

Back in 2005, a Hawaii state audit called out the University of Hawaii System board for approving a budget that gave the flagship Manoa campus $200 million when, auditors said, all but $13 million went to vague or unnecessary requests.

Honolulu attorney Benjamin Kudo, who joined the university’s board in 2011, said he was stunned by the lack of information he was given during the budget process. He said he received a packet of pie charts and a PowerPoint presentation with general information on how the university planned to divide up its funds for areas including teaching, libraries, athletics and facilities across 10 campuses.

Kudo said administrators weren’t initially receptive to requests that he and another new board member, Jan Sullivan, made for more detail, including a comparison of projected versus actual spending. Kudo, who served on the board until 2022, recalled being accused of trying to micromanage the $1 billion budget.

For the full story, see:

Melissa Korn, Andrea Fuller and Jennifer S. Forsyth. “State Colleges ‘Devour’ Money, And Students Foot the Bill.” The Wall Street Journal (Friday, Aug 11, 2023): A1 & A9.

(Note: ellipses added.)

(Note: the online version of the story has the date August 10, 2023, and has the title “Colleges Spend Like There’s No Tomorrow. ‘These Places Are Just Devouring Money.’”)

For Some Cancers, Less Aggressive Therapies Can Be Equally Effective, With Fewer Damaging Side-Effects

(p. A1) Doctors are coalescing around the ironic idea that for some cancer treatment, less can be better.

Some patients with cervical and pancreatic cancer can do as well with less invasive surgery, according to research presented at the American Society of Clinical Oncology conference in Chicago over the weekend. Other studies at the annual meeting showed some patients with rectal cancer or Hodgkin lymphoma can safely get less radiation.

The findings expand a body of evidence doctors are using to design treatment plans that aim to reduce side effects and costs. They call the strategy de-escalation: cutting back on some therapies to improve a patient’s quality of life without hurting their odds of survival.

Newer treatments and tests are extending patients’ lives and moving cancer care away from a blunt, one-size-fits-all approach. On the strength of studies like those presented in Chicago, doctors are getting better at determining who needs the most aggressive care and who can get away with less treatment and less collateral damage.

. . .

(p. A7) In another study presented at the conference of some 1,200 patients with rectal cancer that had spread to nearby tissue or lymph nodes, about half got standard chemotherapy and radiation before surgery. The others got more aggressive chemotherapy but no radiation, unless their tumors failed to shrink by at least 20%. About 10% of those patients needed the radiation, according to the study, which was published in the New England Journal of Medicine and the Journal of Clinical Oncology.

At five years, results from the protocols were similar, suggesting that many rectal cancer patients can safely skip radiation that increases risks of pelvic fractures, bowel and sexual dysfunction and infertility, researchers said.

“We can spare select patients,” said Dr. Pamela Kunz, director of the Center for Gastrointestinal Cancers at Yale Cancer Center. “This trial is really less is more.”

The patients who avoided radiation by undergoing more aggressive chemotherapy experienced more, different shorter-term side effects including appetite loss, fatigue and nervous-system damage. Some patients might still opt to get the radiation, researchers said.

. . .

The Food and Drug Administration this year released draft guidance to cancer-drug developers on how to determine the best dose for new therapies. Doses were traditionally set at the highest tolerable amount, since the drugs were less precise and patients needed them quickly.

For the full story, see:

Brianna Abbott. “Cancer Doctors Rethink Aggressive Treatments.” The Wall Street Journal (Tuesday, June 6, 2023): A1 & A7.

(Note: ellipses added.)

(Note: the online version of the story was updated June 5, 2023, and has the same title as the print version. The wording in the last sentence quoted above follows the more nuanced online version of the sentence.)