Alternative Medicine The Risks of Untested and Unregulated Remedies

By: Marcia Angell, M.D. and Jerome P. Kassirer, M.D.

From: The New England Journal of Medicine, Vol. 339, Number 12, 1998.
5J. Geffen
1.
What is there about alternative medicine that sets it apart from ordinary
medicine? The term refers to a remarkably heterogeneous group of theories and
practices as disparate as homeopathy, therapeutic touch, imagery, and herbal
10medicine. What unites them? Eisenberg et al. defined alternative medicine (now often
called complementary medicine) as medical interventions not taught widely at U.S.
medical schools or generally available at U.S. hospitals. That is not a very
satisfactory definition, especially since many alternative remedies have recently found
their way into the medical mainstream. Medical schools teach alternative medicine,
15hospitals and health maintenance organizations offer it, and laws in some states
require health plans to cover it. It also constitutes a huge and rapidly growing
industry, in which major pharmaceutical companies are now participating.
2.
What most sets alternative medicine apart, in our view, is that it has not been
scientifically tested and its advocates largely deny the need for such testing. By
20testing, we mean the marshaling of rigorous evidence of safety and efficacy, as
required by the Food and Drug Administration (FDA) for the approval of drugs and
by the best peer-reviewed medical journals for the publication of research reports. Of
course, many treatments used in conventional medicine have not been rigorously
tested, either, but the scientific community generally acknowledges that this is a
25failing that needs to be remedied. Many advocates of alternative medicine, in contrast,
believe the scientific method is simply not applicable to their remedies. They rely
instead on anecdotes and theories.
3.
In 1992, Congress established within the National Institutes of Health an Office
of Alternative Medicine to evaluate alternative remedies. So far, the results have been
30disappointing. For example, of the 30 research grants the office awarded in 1993, 28
have resulted in final reports (abstracts) that are listed in the offices public on-line
data base. But a Medline search almost six years after the grants were awarded
revealed that only 9 of the 28 resulted in published papers. Five were in 2 journals not
included among the 3500 journal titles in the Countway Library of Medicines
35collection. Of the other four studies, none was a controlled clinical trial that would
allow any conclusions to be drawn about the efficacy of an alternative treatment.
4.
It might be argued that conventional medicine relies on anecdotes, too, some of
which are published as case reports in peer-reviewed journals. But these case reports
differ from the anecdotes of alternative medicine. They describe a well-documented
40new finding in a defined setting. If, for example, the Journal were to receive a paper
describing a patients recovery from cancer of the pancreas after he had ingested a

rhubarb diet, we would require documentation of the disease and its extent, we would
ask about other, similar patients who did not recover after eating rhubarb, and we
might suggest trying the diet on other patients. If the answers to these and other
45questions were satisfactory, we might publish a case report not to announce a
remedy, but only to suggest a hypothesis that should be tested in a proper clinical trial.
In contrast, anecdotes about alternative remedies (usually published in books and
magazines for the public) have no such documentation and are considered sufficient
in themselves as support for therapeutic claims.
505.
Alternative medicine also distinguishes itself by an ideology that largely ignores
biologic mechanisms, often disparages modern science, and relies on what are
purported to be ancient practices and natural remedies (which are seen as somehow
being simultaneously more potent and less toxic than conventional medicine).
Accordingly, herbs or mixtures of herbs are considered superior to the active
55compounds isolated in the laboratory. And healing methods such as homeopathy and
therapeutic touch are fervently promoted despite not only the lack of good clinical
evidence of effectiveness, but the presence of a rationale that violates fundamental
scientific laws surely a circumstance that requires more, rather than less, evidence.
6.
Of all forms of alternative treatment, the most common is herbal medicine. Until
60the 20th century, most remedies were botanicals, a few of which were found through
trial and error to be helpful. For example, purple foxglove was found to be helpful for
dropsy, the opium poppy for pain, cough, and diarrhea, and cinchona bark for fever.
But therapeutic successes with botanicals came at great human cost. The indications
for using a given botanical were ill defined, dosage was arbitrary because the con65centrations of the active ingredient were unknown, and all manner of contaminants
were often present. More important, many of the remedies simply did not work, and
some were harmful or even deadly. The only way to separate the beneficial from the
useless or hazardous was through anecdotes relayed mainly by word of mouth.
7.
All that began to change in the 20th century as a result of rapid advances in
70medical science. The emergence of sophisticated chemical and pharmacologic
methods meant that we could identify and purify the active ingredients in botanicals
and study them. Digitalis was extracted from the purple foxglove, morphine from the
opium poppy, and quinine from cinchona bark. Furthermore, once the chemistry was
understood, it was possible to synthesize related molecules with more desirable
75properties. For example, penicillin was fortuitously discovered when penicillium mold
contaminated some bacterial cultures. Isolating and characterizing it permitted the
synthesis of a wide variety of related antibiotics with different spectrums of activity.
8.
In addition, powerful epidemiologic tools were developed for testing potential
remedies. In particular, the evolution of the randomized, controlled clinical trial
80enabled researchers to study with precision the safety, efficacy, and dose effects of
proposed treatments and the indications for them. No longer do we have to rely on
trial and error and anecdotes. We have learned to ask for and expect statistically

reliable evidence before accepting conclusions about remedies. Without such

evidence, the FDA will not permit a drug to be marketed.
859.
The results of these advances have been spectacular. As examples, we now
know that treatment with aspirin, heparin, thrombolytic agents, and beta-adrenergic
blockers greatly reduces mortality from myocardial infarction; antibiotics heal peptic
ulcers; and a cocktail of cytotoxic drugs can cure most cases of childhood leukemia.
Also in this century, we have developed and tested vaccines against a great many
90infectious scourges, and we have a vast arsenal of effective antibiotics for many
others. In less than a century, life expectancy in the United States has increased by
three decades, in part because of better sanitation and living standards, but in large
part because of advances in medicine realized through rigorous testing. Other
countries lagged behind, but as scientific medicine became universal, all countries
95affluent enough to afford it saw the same benefits.
10. Now, with the increased interest in alternative medicine, we see a reversion to
irrational approaches to medical practice, even while scientific medicine is making
some of its most dramatic advances. Exploring the reasons for this paradox is outside
the scope of this editorial, but it is probably in part a matter of disillusionment with
100the often hurried and impersonal care delivered by conventional physicians, as well as
the harsh treatments that may be necessary for life-threatening diseases.
11. Fortunately, most untested herbal remedies are probably harmless. In addition,
they seem to be used primarily by people who are healthy and believe the remedies
will help them stay that way, or by people who have common, relatively minor
105problems, such as backache or fatigue. Most such people would probably seek out
conventional doctors if they had indications of serious disease, such as crushing chest
pain, a mass in the breast, or blood in the urine. Still, uncertainty about whether
symptoms are serious could result in a harmful delay in getting treatment that has
been proved effective. And some people may embrace alternative medicine
110exclusively, putting themselves in great danger.
12. Also in this issue, we see that there are risks of alternative medicine in addition
to that of failing to receive effective treatment. Slifman and her colleagues report a
case of digitalis toxicity in a young woman who had ingested a contaminated herbal
concoction. Ko reports finding widespread inconsistencies and adulterations in his
115analysis of Asian patent medicines. LoVecchio et al. report on a patient who suffered
central nervous system depression after ingesting a substance sold in health-food
stores as a growth hormone stimulator, and Beigel and colleagues describe the
puzzling clinical course of a patient in whom lead poisoning developed after he took
an Indian herbal remedy for his diabetes. These are without doubt simply examples of
120what will be a rapidly growing problem.
13. What about the FDA? Shouldnt it be monitoring the safety and efficacy of
these remedies? Not any longer, according to the U.S. Congress. In response to the
lobbying efforts of the multibillion-dollar dietary supplement industry, Congress in

1994 exempted their products from FDA regulation. (Homeopathic remedies have
125been exempted since 1938.) Since then, these products have flooded the market,
subject only to the scruples of their manufacturers. They may contain the substances
listed on the label in the amounts claimed, but they need not, and there is no one to
prevent their sale if they dont. In analyses of ginseng products, for example, the
amount of the active ingredient in each pill varied by as much as a factor of 10 among
130brands that were labeled as containing the same amount. Some brands contained none
at all.
14. Herbal remedies may also be sold without any knowledge of their mechanism of
action. In this issue of the Journal, DiPaola and his colleagues report that the herbal
mixture called PC-SPES (PC for prostate cancer, and spes the Latin for hope) has
135substantial estrogenic activity. Yet this substance is promoted as bolstering the
immune system in patients with prostate cancer that is refractory to treatment with
estrogen. Many men taking PC-SPES have thus received varying amounts of
hormonal treatment without knowing it, some in addition to the estrogen treatments
given to them by their conventional physicians.
14015. The only legal requirement in the sale of such products is that they not be
promoted as preventing or treating disease. To comply with that stipulation, their
labeling has risen to an art form of doublespeak (witness the name PC-SPES). Not
only are they sold under the euphemistic rubric dietary supplements, but also the
medical uses for which they are sold are merely insinuated. Nevertheless, it is clear
145what is meant. Shark cartilage (priced in a local drugstore at more than $3 for a days
dose) is promoted on its label to maintain proper bone and joint function, saw
palmetto to promote prostate health, and horse-chestnut seed extract to promote
leg vein health. Anyone can walk into a health-food store and unwittingly buy PCSPES with unknown amounts of estrogenic activity, plaintain laced with digitalis, or
150Indian herbs contaminated with heavy metals. Caveat emptor*. The FDA can intervene
only after the fact, when it is shown that a product is harmful.
16. It is time for the scientific community to stop giving alternative medicine a free
ride. There cannot be two kinds of medicine conventional and alternative. There is
only medicine that has been adequately tested and medicine that has not, medicine
155that works and medicine that may or may not work. Once a treatment has been tested
rigorously, it no longer matters whether it was considered alternative at the outset. If it
is found to be reasonably safe and effective, it will be accepted. But assertions,
speculation, and testimonials do not substitute for evidence. Alternative treatments
should be subjected to scientific testing no less rigorous than that required for
160conventional treatments.

5* Let the buyer beware

MANAGING COMMUNICATION WITH YOUNG PEOPLE WHO HAVE A POTENTIALLY

LIFE THREATENING CHRONIC ILLNESS: QUALITATIVE STUDY OF PATIENTS AND
PARENTS
BMJ 2003; 326 doi: http://dx.doi.org/10.1136/bmj.326.7384.305 (Published 08 February

1652003)Cite this as: BMJ 2003;326:305

Bridget Young (B.Young@hull.ac.uk), lecturera, Mary Dixon-Woods, senior
lecturerb, Kate C Windridge, research fellowc, David Heney,
consultantd
170Introduction
Much attention has focused on the benefits of open communication between
adult patients with chronic illnesses and health professionals. Although the
evidence is more limited for young people, recent guidance from the BMA has
supported the principle of informing young patients in all but exceptional
175circumstances. However, implementation of this recommendation, particularly
for serious illness, is far from straightforward. Observational studies show that
young people are often relegated to a non-participant status in consultations.
Parents also feel ill equipped to handle discussions with their children about
life and death issues and may be reluctant to engage in open communication
180with them about a potentially life threatening illness. We investigated the
views of young people and their parents on the management of
communication about their illness and how they perceive the role of their
parents in this process.
185Setting the tone: the form of disclosure
The period around diagnosis was important in influencing patterns of
communication. Parents described assuming an executive-like role during this
time, managing what, when, and how their children were told about their
illness. This role was tacitly negotiated with them by doctors: the diagnosis
190was usually disclosed by doctors to parents first, without the patient present.
Rarely (two families), the parents and patient were told together. In choosing
to disclose to parents first, doctors were acknowledging the authority of the
parental role. Subsequent discussions between parents and doctors about
how communication with the patient should be managed served to recognise
195the value of parents' special knowledge of their child's character and to
establish the primacy of the parental voice in managing communication with
young people.
Children expressed a range of views about the form of the disclosure: a few
thought it was better to hear the news at the same time as their parents, some
200thought it was more appropriate for their parents to be told first, and others
reported no strong feelings either way. In contrast, all but two parents who
expressed a preference wanted to be given the diagnosis without their child
being present, and before the patient was told. These accounts reflected
parents' need to manage their identity as strong and optimistic, and their fear
205of upsetting their child. Parents expressed considerable apprehension about
breaking down in their child's presence, and thought they would be better

able to support their son or daughter if they could first compose themselves.
The young person's presence when breaking the news could also prevent
parents from asking key questions. Other parents conveyed their dread of the
210moment when their child would be told and the difficulties of dealing with their
reactions. Although doctors usually urged otherwise, a few parents opted to
dilute or delay what their child was told.
The role of parents: communication executives and information boundary
215
setting
Over the course of the illness, some families described adjusting their
management of communication away from the executive controlling and
directive model towards a partnership based model, with the young person
and parent roles becoming more equal and communication becoming more
220open. In other cases, parents described continuing to orchestrate when and
what their child was told. The young people talked in detail about the part that
their parents played in communication, describing the overlapping roles that
their parents performed within both the executive and partnership models
(box). Parents' accounts of their roles were broadly similar to those described
225by the patients. Both parents and young people described how parents were
often involved in setting information boundaries and in censoring or filtering
what the young people were told.
The young people differed in the extent to which they were satisfied with the
executive style of communication. A few, particularly those whose priority was
230to ensure that their main source of information was someone with whom they
had a close and longstanding relationship, seemed to welcome it. However,
the accounts of other patients suggested that they thought communication
was constrained by their parents. Some referred to the inability or
unwillingness of parents to answer their questions; others questioned how
235the information boundaries had been defined and expressed unease at the
perceived disparity between how much information they had been given and
what their parents had been told. Clearly, parental involvement in
communication, particularly in setting information boundaries, could at times
be problematic for young people, particularly if there was discordance
240between a patient's need to know and a parent's efforts to limit their access
to information. But this did not mean that the young people regarded their
parents' involvement in communication as inappropriate in principle. Young
people's accounts showed how their preferences were fluid and depended on
context. Reflecting work with adult patients on awareness contexts, and
245differing levels of knowledge about life threatening illness, almost all the
young people at times embraced, or even actively cultivated, their parents'
role as buffers to limit their exposure to information

Young people's social positioning, communication, and relationships with

250
health professionals
Prominent in the young people's and parents' accounts were the issues of the
young people's social positioning (relative to adults) and questions about their
dependency, vulnerability, and competence. Young people were acutely aware
of their own position and talked in detail about the importance of age and
255maturity in mediating what and how young people ought to be told.
Importantly, however, their age was not particularly useful in explaining either
their own or their parents' accounts of communication. For example, some of
the youngest wanted detailed information whereas one of the oldest wanted
only the basics. There was also variability in the young people's beliefs
260about the ages at which specific competencies could be expected and the
appropriateness of health professionals' use of child friendly language and
communication techniques. What united all of the accounts, however, was
young people's use of their parents as a resource to manage communication.
Their ability to use parents in precisely the way they preferred depended,
265however, on their parents' cooperation.
Young people's dependency on their parents as brokers in the
communication process arose because they did not, for the most part, see
themselves as having direct access to information through their own
interactions with health professionals, particularly doctors. The young people
270saw themselves as occupying a marginal position in consultations, and some
thought that their priorities were of little interest to medicine. Consultations
were largely carried out between parents and professionals, and seemed to
leave the young people without a voice. The young people therefore
subjected their interactions with health professionals to considerable critical
275scrutiny, and they were highly conscious of the differences in the status and
working practices of different categories of professionals, particularly doctors
and nurses. Some did not see emotional labour as a duty of doctors,
whereas they did see it as something that nurses undertook, and many felt
more at ease talking to nurses.
280
Discussion
Implementing open communication with young people who are seriously ill is
problematic. Parents have a range of roles in such communication, and
professional practices affirm the primacy of parents in decisions about
285managing this communication. The role of parents has profound implications
for how professionals communicate with young people who are seriously ill.
The roles undertaken by parents in our study both facilitated and constrained
communication. The young people used their parents to manage the burden
of communication but also said how doctor-parent-patient encounters tended
290to marginalise them. This marginalisation has been reported in observational
studies, and it is interesting that the young people themselves commented on
this problem. Their non-participant status can conflict with their requirements
to make sense of their illness and to have their priorities taken into account.
They used their parents as envoys and information brokers. This could,
295however, leave them uneasy about what had been discussed when they had
not been present. However, they also sought at times to be protected from

threatening information, and then welcomed the role of their parents as

buffers. Parents find the task of managing communication with their children
enormously complex, which is influenced by their need to construct a
300parenting identity that they hope will protect their children's wellbeing and
sponsor an optimistic version of reality.
Our study complements recent work that explores the relevance of the social
positioning of children and cultural beliefs about childhood in young people's
experiences of health care. It also shows that the relation between young
305people's ages and their preferences for communication is not straightforward,
as has also been shown in studies on young people's consent for surgery. Our
characterisation of the parents' executive role is supported by both the young
people's and the parents' accounts: as well as lending trustworthiness to our
conclusions, accessing the accounts of both parties has also highlighted the
310difficulties that health professionals face in balancing the conflicting priorities
of young people and parents. Our study did not address the influence of sex,
ethnicity, social class, and the nature of the illness on how communication is
managed. Patient's age was not particularly valuable in explaining the
management of communication, but this may be due to the limitations of our
315sampling. Theoretical sampling would help to access families and
professionals from a range of different paediatric settings to investigate the
circumstances under which parents' executive role constrains or facilitates
young people's communication and is concordant or discordant with young
people's requirements.
320Without undermining the role of parents, professionals must help them to
consider how their child's interests might best be served. This means both
regulating the young people's access to information and helping parents to
overcome their urge to protect by withholding information. The young people
in our study clearly wanted their parents to be involved in communication but
325were not always satisfied with how communication was managed.
Differences between young people reflect a range of factors, probably
including the degree of congruence between a young person's desire to be
involved in communication and the extent to which parents limited their
child's access to information. It is clear that professionals need to consider
330delegating less of the responsibility for communication to parents. They also
need to remain alert to the possibility that the needs and preferences of some
young people and parents may be discordant, and that their position in this
regard is likely to vary during the illness. Perhaps most importantly,
professionals need to remain aware of how parents' executive role, and the
335power relations of professional-parent-child encounters, can be a major
obstacle in forging successful relationships between health professionals and
young people.
DOES ABORTION REALLY REDUCE CRIME?
October 29, 2012 (HLIWorldWatch.org ) - Throughout the Twentieth Century,
340eugenicists promoted abortion and birth control, claiming that if the lower

classes would only have fewer children, crime would also decline. This was
one of the primary themes of Margaret Sangers Birth Control Review, in
which Montgomery Mulford wrote that I am of the belief that the acceptance
of birth control by society, and its frank teaching, can help diminish criminal
345activity!1
This theme still resonates strongly with many people today. The best-known
study of the abortion-crime connection was performed by John J. Donohue III
and Steven D. Levitt in 2001. In Harvard Universitys Quarterly Journal of
Economics, they concluded that Legalized abortion contributed significantly
350to recent crime reductions. Legalized abortion appears to account for as
much as 50 percent of the recent drop in crime. The authors noted, Crime
began to fall roughly 18 years after abortion legalization, and that the social
benefit of this decrease in crime is about $30 billion annually.2
Donohue and Levitt wrote that, since 1991 18 years after Roe v. Wade
355legalized abortion murder rates have fallen faster than at any time since
the end of Prohibition in 1933. They added that the five states that legalized
abortion earlier than 1973 [New York, California, Washington, Hawaii and
Alaska] also experienced earlier declines in crime. Finally, they found that
states with especially high abortion rates in the 1970s and 1980s had equally
360dramatic crime reductions in the 1990s.3
Levitt went on to co-author the 2005 bestseller Freakonomics, in which he
reiterated his thesis that the legalization of abortion is responsible for half of
the recent drop in violent crime.
Prominent pro-abortion groups and leaders immediately seized on the results
365of the Donohue-Levitt study and used them as justification for promoting and
funding the practice of abortion. For example, Canadian abortionist Henry
Morgentaler, in an op-ed piece heartlessly entitled Its Better for Us that They
Died, declared moral vindication and grumbled that he had been saying for
decades that abortion would reduce crime.4
370Statistical Refutation
Donohue and Levitt are certainly correct when they say that violent and
property crimes are down by astonishing numbers since 1991. The rate of
murder has decreased 49 percent; forcible rapes have plunged 32 percent;
robberies by 50 percent; aggravated assault by 39 percent; and property
375crimes by 41 percent.5 Additionally, states with very high abortion rates in the

1970s and 1980s also had correspondingly dramatic crime reductions in the
1990s.6
While Donohue and Levitt were doing their research, however, other scientists
were arriving at opposite results.
380Law professors John R. Lott, Jr. of Yale Law School and John E. Whitley of
the University of Adelaide found that legalizing abortion increased murder
rates by up to seven percent. They concluded that legalizing abortion is a
contributing factor to the great increase in out-of-wedlock births and single
parent families, which in turn contribute to increased crime rates. Since 1970,
385the percentage of single-parent households in the United States has nearly
tripled, from 11 percent to 32 percent, and the percentage of out-of-wedlock
births has nearly quadrupled, from 11 percent to 43 percent of all children.7
Children born out-of-wedlock and raised by only one parent have a
significantly higher incidence of crime.
390There are many other fundamental problems with the conclusion that
legalized abortion leads to a decrease in crime.
Statistician David Murray confirmed that young males between the ages of 17
and 25 commit the majority of crimes. However, if abortion had reduced crime,
the crime rates in the United States would have dropped first among young
395people. They did not. Instead, the number of crimes committed by older
people dropped first. Nearly 60% of the decline in murder since 1990 involved
killers aged 25 and older who were born before Roe v. Wade.8
Murray also found that other nations with high abortion rates showed a large
increase in crime about eighteen years after they legalized abortion. For
400example, in Great Britain, which legalized abortion in 1968, violent crime has
been rising steeply since about 1985 exactly when it should have been
declining, according to the Donohue-Levitt thesis. Additionally, Russia, with
the highest abortion rate on earth, has experienced a tidal wave of every kind
of violent crime following the breakup of the Soviet Union.9
405FBI statistics showed that the murder rate in 1993 for 14- to 17-year-olds in
the USA (born in the years 1975-1979, which had very high abortion rates)
was 3.6 times higher than that of kids who were the same age in 1984 (who
were born in the pre-legalization years of 1966-1970). Additionally, since Black
women were having abortions at a much higher rate than White women, we
410should have expected the murder rate among Black youth to have declined

beginning in about 1991. Instead, it increased more than five hundred percent
from 1984 to 1993.10
Finally, the huge increase in violent crime that peaked in 1991 and then began
to decline is more closely related to the crack epidemic, not abortion. The
415Donohue-Levitt study confirms that the crime rate rose and fell exactly where
crack cocaine was most easily available in the large cities and among
young Black males.11 This is also confirmed by the rise in crime during the
time period 1984 to 1991, after a decline from 1980 to 1984. If abortion were
the primary cause of a decline in violent crime, the crime rate would have
420been relatively stable during the time period 1980 to 1991.
Moral Refutation
The central thesis of the Donohue-Levitt study is a refinement of the proabortion slogan Every child a wanted child. They said that because a difficult
home environment leads to an increased risk of criminal activity, increased
425abortion would reduced unwantedness and therefore lowered criminal activity.
However, although criminals may more likely come from a difficult home
environment, many talented and gifted individuals have as well, including:
John Lennon, Charlie Chaplin, Louis Armstrong, playwright Eugene ONeill,
Audrey Hepburn, James Dean, Merle Haggard, comedian Tim Allen and,
430ironically, the politician who has most fanatically supported abortion in the
history of the nation, Barack Obama.12
The point here is this: No matter how terrible a home environment is, no child
is certain to become a criminal. Crime is not programmed into our DNA. Any
program intended to help exterminate the preborn children of the poor is
435simply pre-emptive capital punishment curiously supported by many of the
same people who oppose the death penalty for adult criminals.
Donohue and Levitt also say in their study that legalized abortion has caused
a social benefit due to reduced crime rates that amounts to $30 billion
annually. This is a narrow and short-sighted view, completely neglecting the
440benefits each person contributes to society. The direct cost of each abortion to
society in terms of lost consumption and taxes paid amounts to, on average,
$3,720,000.13 There are about 1,210,000 abortions performed annually in the
United States. This means that the total direct cost of abortion in the United
States every single yearis about four and a half trillion dollars.
445So if we use Donohue and Levitts benefit numbers, for every dollar of social
benefit we accrue from reduced crime rates due to abortion, we lose $150.

Finally, in the last paragraph of their paper, Donohue and Levitt agree that an
equivalent reduction in crime would be caused by providing better
environments for those children at greatest risk for future crime.
450So the question for all of us, pro-lifers and pro-choicers alike, is this: Do we
want to attack the symptom or the cause? Do we clumsily and bloodily try to
eliminate even more criminals through the mechanisms of eugenics, abortion,
sterilization and birth control (programs that have proved themselves unequal
to the task), or do we embrace the proven remedies of strengthening family
455life, enforcing the law and providing education, resources and better living
conditions for the poor?
Stephen Levitt believes that working on his controversial research actually
moved him further toward a pro-life position. He agrees that one could
conclude from the evidence he and Levitt compiled that the answer isnt more
460abortions but better education and living conditions for the poor.14
Margaret Sanger advocated the elimination of human weeds many years
ago in the United States. Her eugenics programs did not improve the lot of the
poor all she did was turn large poor families into small poor families.
Current-day eugenicists are pushing the same failed program.
465Dr. Brian Clowes is the director of education and research at Human Life
International (HLI), the worlds largest international pro-life and pro-family
organization. A version of this article appeared in The Wanderer.