Letters

At Your Own Risk

Your report on clinical trials paints a vivid picture of the tragedies that individual research subjects have endured, but it does not adequately depict the millions of patients who have benefited from such trials [MEDICINE, April 22]. Tests of experimental medications provide access to treatments that would otherwise be unavailable or cost prohibitive. Oversight of clinical trials is essential, and an investigation of the review process may be necessary, but your article may have had the sad effect of making patients less inclined to participate. JEFFREY J. WALLINE Columbus, Ohio

Thank you for examining the often overlooked public-health crisis of research on human subjects. I have worked in the field for two years at a major research university. I have been astounded by the lack of concern of principal investigators and their study coordinators for the safety of the subjects in their clinical trials. They will use every device, subtle and overt, to downplay trial risks. I would definitely advise my family and friends not to enroll in a clinical trial. If you are taking part in a trial, you should be aware that your safety is often the last priority. And never forget that you are not a patient being treated; you are a subject in an experiment. NAME WITHHELD BY REQUEST Tampa, Fla.

There are horror stories in any field. You should have included specific drug trials that have resulted in saving lives, and there have been many. VALARIE MCGEE Atlanta

Dow Agrosciences' clinical trial of chlorpyrifos [an active ingredient in pesticides], to which you referred, was conducted in 1998 in a reputable clinical laboratory and in full compliance with all relevant U.S. and international laws, including prior review and approval by medical professionals. The volunteers (average age: 30) were fully informed; they freely agreed to take part in the tests and understood that they could end their participation at any time. Prior to conducting these trials, extensive animal research had shown that the doses to be used would not harm the participants. As expected, the trials did not result in any exposure-related effects. MICHAEL C. SHAW, PH.D. Dow AgroSciences Indianapolis, Ind.

Clinical researchers believe in their treatments, as they should. Yet this belief needs to be scrutinized by unbiased scientists working in the patients' interest. Our trials can never be too safe. But we should not lose sight of the fact that our system has given rise to spectacular advances in cancer therapy, including Gleevec for leukemia; the control of aids; treatments for breast cancer; and others. As a new era of molecular genetic research dawns, we need to make certain that the strides we make in devising new therapies are matched by progress in ensuring patient safety. FRANK G. HALUSKA, M.D., PH.D. Director, Melanoma Program Massachusetts General Hospital Boston

As a survivor of prostate cancer, I owe my life to those on the front line of medical research, the courageous participants in clinical trials. But to those researchers who use shoddy procedures and put their patients at risk, as well as those institutions whose lax oversight undermines public trust, shame! Without well-designed research efforts, fully informed patients and strict oversight, we will not be able to find and develop the medicines and therapies we desperately need to treat debilitating diseases. As a board member of Friends of Cancer Research and a cancer survivor, I am all for clinical trials, but they should be done the right way. GENERAL H. NORMAN SCHWARZKOPF U.S. Army, Retired Washington

I was taken aback to read that some people involved in clinical trials, especially pregnant women, did not find out about a medication's possible side effects before participating. A drug that is only in the testing stages should be regarded as unsafe until proved otherwise. It is outrageous that a physician would allow a pregnant woman to take part in a test. Are we so hungry for cures that we are willing to risk unborn human lives? JENNIFER HOYDICZ Ridgefield, N.J.

I was shocked by the amount of risk for those who participate in medical trials. There should be an outside agency regulating all trials, not just a group that steps in when a drug causes death or severe side effects. Companies should be forced to provide information on the risk and all possible side effects to keep the participants as safe as possible. As long as profit is the main goal of the researchers, however, patient safety will be something of a pipe dream. TODD KITCHENS Emporia, Kans.

Stumbling Giant

Re your report "The Engine Stalls at AOL" [BUSINESS, April 22]: My family just dropped AOL in favor of MSN. Getting through to AOL proved to be more difficult than talking to someone at the White House. AOL seems to have copped the attitude that "we are the biggest, and we don't give a damn what you think of us." Getting online took forever. Now that we have a new service, we have not had one problem, and we are online instantly. Perhaps AOL should take a cue from its competitors on how to treat its customers and not focus so hard on being the biggest. PAUL D. PENISTON St. Ann, Mo.

I can't say I'm surprised that AOL is experiencing difficulties, since I know how wasteful its marketing strategy is. I have a huge pile of free-trial AOL CDs that were sent to me despite my having repeatedly told AOL that I am very satisfied with my present Internet provider. NICK GODWIN Edinburgh

What propelled American consumers in droves to buy those enormous black-and-white TV sets in the early days? That furniture-size hardware was a must-have to watch Milton Berle. These days we'd call that a content-driven business model. And it will work just as well for broadband Internet. What AOL needs more than anything right now is a hit Web show. Throw in a cable-TV tie-in for good measure, and AOL's chief officer, Robert Pittman, will see that the company is on top once again. ALLAN HOVING Westport, Conn.

Institutional Blindness

I have the highest praise for your story "In Plain Sight" about Roman Catholic priest Paul Shanley and his interest in pedophilia [RELIGION, April 22]. I'm pleased that TIME has contributed to the effort to expose the incomprehensible crime of child sex abuse. For priests to violate our children and have their acts covered up by their peers is a crime of the highest degree. It is time for the Catholic Church to answer not only to God and Rome but also to the courts. ROBERT WILLIAM ZERBY St. Croix, Virgin Islands

If a senior manager of a different organization had covered up the pedophilia of a subordinate and transferred that person elsewhere to continue his practices, the criminal-justice system would have prosecuted that manager for hiding evidence. Why aren't the bishops and Cardinals being actively charged under federal and state law? Their motives appear to be those typical of an organization: protect the people within and ignore those who have been hurt. TED JOHNSTON Atherton, Calif.

Who Dares Negotiate?

If the U.S. wants the Palestinians and the Israelis to talk peace, we should not wait to see who will be the first to blink [WORLD, April 22]. The U.S. provides a great deal of money and aid to both groups. Perhaps if we froze the aid, the leaders of both sides would take notice of our request for peace in the region. MARGARET GRIFFITH Roxboro, N.C.

Would we arrive at peace more quickly if everyone involved in the negotiations were required to spend one week each month serving on the front lines in the Middle East? MERLE FERRIS Independence, Mo.

The tragic escalation of fighting in the Middle East does not seem to have resulted in any fresh approach to the problems there. Here is a suggestion that is doable, although admittedly far-fetched: send a group of aboriginal leaders from different nations (U.S., Canada, Greenland, Australia, New Zealand) to mediate. They would be more likely to listen to the various views and would have a unique perspective. They certainly know firsthand what it is like to be displaced and to need a homeland. Maybe such an approach could foster greater understanding among the warring parties. RON PENNER Nanaimo, British Columbia

How can we expect any calming of the situation when there are so many dead among Palestinian families, as well as many fatalities on the Israeli side? More killing will cause even more people to stop believing in peace. It will fuel the flames and destruction. How can we demand that people who have lost their homes and their relatives think about peace? It seems impossible unless their leaders truly believe in peace. The killing of innocent people--whether they are Israelis or Palestinians--should be condemned everywhere. MOHAMMAD GHARIPOUR Tehran

Blind Belief in Martyrdom

The insight into the psyche of a suicide bomber, the indoctrination and the final act of pulling the lever to blow oneself up were properly covered in your story "Why Suicide Bombing Is Now All the Rage" [WORLD, April 15]. Attaining martyrdom and blindly believing in this macabre act show to what extremes fanatics will go and present a dangerous situation for the world at large. No country will be safe from suicide bombing if it is widely accepted as a ticket to paradise. If we do not put a stop to it now, this cancer will spread. VALLATH P. DAMODAR Pune, India

If the Palestinians had an army that could flatten Jewish settlers' homes, F-16 fighters that could pound Tel Aviv, Apache helicopters that could "surgically" remove any Israeli or Jewish leader not to their liking, would any Palestinian youth choose to become a suicide bomber? Killing oneself in defense of a cause has been tried by desperate people for centuries. Instead of concentrating on the Palestinians' suicide bombing, the Israelis would be better served by rooting out the causes of such desperation, acknowledging the Palestinians' right to freedom from occupation and giving the Palestinians back their land. NAJWA KHURI-BULOS Amman

As one of the few left-wing Israelis remaining, I cannot say I approve entirely of Israel's actions in the occupied territories. But I believe any Israeli reading your report on suicide bombers can't help but be outraged. Splashing photos of dead terrorists across TIME's pages, without one sympathetic photo of a victim, without condemnation, makes the Palestinians indeed look like martyrs--victims who sacrificed themselves for a noble cause. There is no doubt that the Palestinians are existing under shameful living conditions that become worse with every suicide bombing. The world is quick to criticize, but would any other country react differently if its citizens were robbed of security in their own cities and if one had to think twice about doing the most ordinary, everyday things? DAPHNA REICH Haifa, Israel

Palestinian youths are oppressed and humiliated by Israeli occupation forces, disappointed by Arab countries' policies and ignored by the West. They are barely alive, with little or no hope of a better and dignified existence. They have few choices, but martyrdom gives Palestinian youths the hope of a life in heaven. The solution? A better existence here on Earth. Give them hope. AZZAM ADEL Cairo

Uprising in Venezuela

After the coup d'etat in Venezuela, thousands of democracy fighters demonstrated their support for the government [NOTEBOOK, April 22]. President Hugo Chavez should remain in office until the last day of the term to which he was democratically elected. His days will not be the same sort that other deposed leaders had to live through. ROBERTO F. LETAMENDI Aptos, Calif.

Clarification

In our story "Streets Red With Blood," on the increasing violence in the Middle East [World, March 18], we ran a photo of Israelis holding up their red-painted hands, accompanied by a caption that read, "Voting for Mayhem: Israeli students at a demonstration in Jerusalem rally for more violence, raising paint-dipped hands." Instead, our caption should have more precisely explained the situation shown in the photograph: "Israeli right-wing student activists hold up their hands, painted in red as a symbol of bloodshed, at a demonstration supporting the cancellation of chief Palestinian negotiator Saeb Erakat's lecture at the Hebrew University on Mount Scopus in Jerusalem."