Comparing Birth Control Trials Today to Those in the 60s Ignores a Sea Change in Research Ethics

Vox has a wonderful article on the recently published male birth control study that is a useful corrective to the narrative that falsely equates it to the original studies of The Pill. Though I say ignore their title, too, because it’s also not that helpful of a narrative either. But the content is useful in arguing against what seems like a terrible and callous framing of the study in most commentary. The key line: “And, yes, the rate of side effects in this study was higher than what women typically experience using hormonal birth control.” Also, can we point out if something like 10 women a year at a school like UVA were committing suicide and it might be linked to a medication they were taking, people would probably be concerned? There’s something disturbing about well-off American women mocking these effects that seemed to disproportionately affect men of color (the most side effects were reported from the Indonesian center, followed by the Chilean center).

My bigger concern here, though, is that most people seem to not understand (or are basically ignoring) how modern research ethics works. For instance, the notion of benefits being weighed in the evaluation of continuing the study aren’t merely the potential benefits of the treatment, but the added benefit of acquiring more data. This was an efficacy study (so I think Phase II, or maybe it was combined Phase I/II, although it might be a really small Phase III trial). It seems like the institutional review board felt enough data had been collected to reach conclusions on efficacy that more data didn’t justify the potential high rate of adverse effects. Which also DOES NOT mean that this treatment has been ruled out forever. The authors themselves recommend further development based on the 75% of participants claiming they would use this birth control method if it were available. I imagine they will tweak the formulation a bit before moving on to further trials. Also, it’s sort of amusing that complaints on this come from people who typically think moves toward regulatory approval are controlled by Big Pharma at the expense of patient health.

Yes, this is different than the initial birth control trials. Yes, the women of Puerto Rico were chosen as human guinea pigs. Though it’s worth pointing out another major factor in choosing Puerto Rico was that it actually had a pretty well organized family planning infrastructure in the 50s and 60s. Admittedly, there’s more racism almost certainly coming into play there, because the politics of family planning were super complicated through the early and mid 20th century and there were definitely overlaps between eugenics and family planning. It’s also worth pointing out the study was encouraged by Margaret Sanger (and earlier studies by Planned Parenthood). Also, the FDA didn’t even initially approve Enovid for contraception because the atmosphere was so repressive back then on reproductive health; it was for menstrual disorders but prescribed off-label for contraception, which is why we know so many women desperately wanted the pill. Heck, even the Puerto Rico study was nominally about seeing if the pill helped with breast cancer. It took another year of discussion by the researchers and companies to get the FDA to finally approve contraception as an on-label use. The company making the pill was actually so concerned about the dosage causing side effects they begged for FDA approval for a lower dose just for contraception (see page 27-28 there) but were rebuffed for another year or two and they refused to market the initial dose for solely for contraception. (Also, to clarify, no one is taking these medications anymore. These versions of the pill were phased out in the 80s.)

Was there sexism at play? Absolutely, and I totally get that. But that doesn’t mean the narrative from 2016 neatly maps onto the narrative of the 1950s and 1960s. Which brings me to my last point. If your view of research ethics is primarily colored by the 1960s, that’s terrifying. You know what else happened at the same time as the initial contraception pill studies? The US government was still letting black men die of syphilis in the name of research. The tissue of Henrietta Lacks was still being cultured without the knowledge or consent of anyone in her family. (And the way they were informed was heartbreaking.) People were unknowingly treated or injected with radioactive material (one of many instances is described here in the segment of testimony by Cliff Honicker). One study involved secretly injecting healthy people with cancer cells, and to prove a theme, those cells were descendants of the ones originally cultured from Henrietta Lacks. Heck, there’s the Milgram experiment and then the Stanford Prison Study was in the 70s. The ethics of human experimentation were a mess for most of the 20th century, and really, most of the history of science. Similarly, medical ethics were very different at the time. Which isn’t to justify those things. But don’t ignore that we’ve been working to make science and research more open, collaborative, and just over the last few decades, and people seem caught up in making humorous or spiteful points than continuing that work right now.

(Other aside, it’s worth pointing out that the comparison here probably does have to be to condoms, which you know, skip the side effects though their typical effectiveness rate is worse. Most of the methods don’t obviously change ejaculate, so unless measuring sperm concentration and motility is a couple’s idea of foreplay, sexual partners who don’t know each other well will still probably want a condom [or unfortunately another method, because yes, the system is sexist and women are expected to do more] as assurance. It’s worth pointing out the study design only worked with “stable” couples who were mutually monogamous and planned on staying together for at least a year during the duration of the study, so there presumably was a high degree of trust in these relationships.)

Reclaiming Science as a Liberal Art

What do you think of when someone talks about the liberal arts? Many of you probably think of subjects like English and literature, history, classics, and philosophy. Those are all a good start for a liberal education, but those are only fields in the humanities. Perhaps you think of the social sciences, to help you understand the institutions and actors in our culture; fields like psychology, sociology, or economics. What about subjects like physics, biology, chemistry, or astronomy? Would you ever think of them as belonging to the liberal arts, or would you cordon them off into the STEM fields? I would argue that excluding the sciences from the liberal arts is both historically wrong and harms society.

First, let’s look at the original conception of the liberal arts. Your study would begin with the trivium, the three subjects of grammar, logic, and rhetoric. The trivium has been described as a progression of study into argument. Grammar is concerned with how things are symbolized. Logic is concerned with how things are understood. Rhetoric is concerned with how things are effectively communicated, because what good is it to understand things if you cannot properly share your understanding to other learned people? With its focus on language, the trivium does fit the common stereotype of the liberal arts as a humanistic writing education.

But it is important to understand that the trivium was considered only the beginning of a liberal arts education. It was followed by the supposedly more “serious” quadrivium of arithmetic, geometry, music, and astronomy. The quadrivium is focused on number and can also be viewed as a progression. Arithmetic teaches you about pure numbers. Geometry looks at number to describe space. Music, as it was taught in the quadrivium, focused on the ratios that produce notes and the description of notes in time. Astronomy comes last, as it builds on this knowledge to understand the mathematical patterns in space and time of bodies in the heavens. Only after completing the quadrivium, when one would have a knowledge of both language and numbers, would a student move on to philosophy or theology, the “queen of the liberal arts”.

7 Liberal Arts

The seven liberal arts surrounding philosophy.

Although this progression might seem strange to some, it makes a lot of sense when you consider that science developed out of “natural philosophy”. Understanding what data and observations mean, whether they are from a normal experiment or “big data”, is a philosophical activity. As my professors say, running an experiment without an understanding of what I was measured makes me a technician, not a scientist. Or consider alchemists, who included many great experimentalists who developed some important chemical insights, but are typically excluded from our conception of science because they worked with different philosophical assumptions. The findings of modern science also tie into major questions that define philosophy. What does it say about our place in the universe if there are 10 billion planets like Earth in our galaxy, or when we are connected to all other living things on Earth through chemistry and evolution?

We get the term liberal arts from Latin, artes liberales, the arts or skills that are befitting of a free person. The children of the privileged would pursue those fields. This was in contrast to the mechanical arts – fields like clothesmaking, agriculture, architecture, martial arts, trade, cooking, and metalworking. The mechanical arts were a decent way for someone without status to make a living, but still considered servile and unbecoming of a free (read “noble”) person. This distinction breaks down in modern life because we are no longer that elitist in our approach to liberal education. We think everyone should be “free”, not just an established elite.

More importantly, in a liberal democracy, we think everyone should have some say in how they are governed. Many major issues in modern society relate to scientific understanding and knowledge. To talk about vaccines, you need to have some understanding of the immune system. The discussion over chemicals is very different when you know that we are made up chemicals. It is hard to understand what is at stake in climate change without a knowledge of how Earth’s various geological and environmental systems work and it is hard to evaluate solutions if you don’t know where energy comes from. Or how can we talk about surveillance without understanding how information is obtained and how it is distributed? The Founding Fathers say they had to study politics and war to win freedom for their new nation. As part of a liberal education, Americans today need to learn to science in order to keep theirs.

(Note: This post is based off a speech I gave as part of a contest at UVA. It reflects a view I think is often unconsidered in education discussions, so I wanted to adapt it into a blog post.

As another aside, it’s incredibly interesting people now tend to unambiguously think of social sciences as part of the liberal arts while wavering more on the natural sciences since the idea of a “social” science wasn’t really developed until well after the conception of the liberal arts.)

Why Can’t You Reach the Speed of Light?

A friend from high school had a good question that I wanted to share:
I have a science question!!! Why can’t we travel the speed of light? We know what it is, and that its constant. We’ve even seen footage of it moving along a path (it was a video clip I saw somewhere [Edit to add: there are now two different experiments that have done this. One that requires multiple repeats of the light pulse and a newer technique that can work with just one). So, what is keeping us from moving at that speed? Is it simply an issue of materials not being able to withstand those speeds, or is it that we can’t even propel ourselves or any object fast enough to reach those speeds? And if its the latter, is it an issue of available space/distance required is unattainable, or is it an issue of the payload needed to propel us is simply too high to calculate/unfeasable (is that even a word?) for the project? Does my question even make sense? I got a strange look when I asked someone else…
 This question makes a lot of sense actually, because when we talk about space travel, people often use light-years to discuss vast distances involved and point out how slow our own methods are in comparison. But it actually turns out the road block is fundamental, not just practical. We can’t reach the speed of light, at least in our current understanding of physics, because relativity says this is impossible.

To put it simply, anything with mass can’t reach the speed of light. This is because E=mc2 works in both directions. This equation means that the energy of something is its mass times the speed of light squared. In chemistry (or a more advanced physics class), you may have talked about the mass defect of some radioactive compounds. The mass defect is the difference in mass before and after certain nuclear reactions, which was actually converted into energy. (This energy is what is exploited in nuclear power and nuclear weapons. Multiplying by the speed of light square means even a little mass equals a lot of energy. The Little Boy bomb dropped on Hiroshima had 140 pounds of uranium, and no more than two pounds of that are believed to have undergone fission to produce the nearly 16 kiloton blast.)

But it also turns out that as something with mass goes faster, its kinetic energy also turns into extra mass. This “relativistic mass” greatly increases as you approach the speed of light. So the faster something gets, the heavier it becomes and the more energy you need to accelerate it. It’s worth pointing out that the accelerating object hasn’t actually gained material – if your spaceship was initially say 20 moles of unobtanium, it is still 20 moles of material even at 99% the speed of light. Instead, the increase in “mass” is due to the geometry of spacetime as the object moves through it. In fact, this is why some physicists don’t like using the term “relativistic mass” and would prefer to focus on the relativistic descriptions of energy and momentum. What’s also really interesting is that the math underlying this in special relativity also implies that anything that doesn’t have mass HAS to travel at the speed of light.

A graph with X-axis showing speed relative to light and Y-axis showing energy. A line representing the kinetic energy the object expoentially increases it approach light speed.

The kinetic energy of a 1 kg object at various fractions of the speed of light. For reference, 10^18 J is about a tenth of United States’ annual electrical energy consumption.

The graph above represents  the (relativistically corrected) kinetic energy of an 1 kilogram (2.2 pound) object at different speeds. You can basically think of it as representing how much energy you need to impart into the object to reach that speed. In the graph, I started at one ten thousandth the speed of light, which is about twice the speed the New Horizons probe was launched at. I ended it at 99.99% of the speed of light. Just to get to 99.999% of the speed of light would have brought the maximum up another order of magnitude.

Where are all the engineering blogs?

I was browsing through Dynamic Ecology recently on my reader to catch up on end-of-2015 posts and was intrigued by one of the author’s comments on why there isn’t really an ecology blogosphere. And though I’ve pondered it before, this makes me wonder where the engineering blogosphere is. I don’t have much evidence to back up the loading of that question, but I’ve been in grad school for engineering for 3.5 years now, and it’s worth noting that I still haven’t heard of any major engineering blogs people follow. And the sheer randomness of Blogmetric’s ranking of engineering blogs seems to corroborate this: only the top 2 of the ranked engineering blogs are tracked to have over 100 visitors a month. A Github list of engineering blogs (which is currently the first result for Googling “engineering blogs”) seems incredibly focused on tech company blogs and IT/programming/development.’s blog seems to have ended without even a goodbye at the end of 2014. Engineer Blogs has been radio silent since September of 2012. And the American Chemical Society’s magazine, Chemical & Engineering News, closed up nearly all of its blogs in mid-2014, with an explanation implying this was because they were viewed as a drain on resources that could be more productively used for other tasks. Chemical Engineering World (which as far as I can tell, is a personal blog and not affiliated to the Indian publication of the same name) seems to have just came back after a hiatus.

The Dynamic Ecology post’s second point on ecology not being very news-driven sounds compelling to me as a reason that could easily cross-apply to engineering, especially if you’re trying to move away from just tech company gossip. Having something well-known to react to can make it easier to post content that’ll actually engage readers because they start searching for it. Point 1 of the Neuroecology post’s on neuroscience lacking a blogosphere because neuroscience bloggers focus more on outreach to general audiences than technical exchanges with each other also seems valid. What’s interesting is the comparison I’m making. As Jeremy from Dynamic Ecology points out, the general science blogosphere is pretty vibrant. He and the Neuroecologist are focusing more on the lack of interacting blogging communities in specific disciplines. Engineering seems to lack this at both levels. I also wonder about some specific issues in engineering that can contribute to this.

  • Is engineering too broad to have a meaningful blogosphere? I see two distinct forces here.
    • First, is the breadth of engineering disciplines. I could see it being hard for there to be a lot of substantive discussion between, say, a chemical engineer and a computer scientist on a broad range of topics.
    • Second, there’s the huge influence of a lot of engineering actually being done in industry. I’m not going to say academic and corporate engineers don’t talk to each other, but it would also be dumb to pretend they have the same interests in how they approach outreach.
  • Is engineering too tied into the science blogosphere? (I wondered a similar thing last time I posted about engineers and outreach) Interested scientists and science writers can (and do) do a good job of explaining concepts and results from related engineering fields. For instance, Dot Physics is written by a physicist who routinely covers topics that are related to technology and engineering. On the opposite end, I clearly try to cover science topics that I think I can explain, even if I’m not experts in them. Randall Munroe straddles the border a lot in What If? and Thing Explainer.
  • You might think I’m treading around one obvious potential component of an engineering blogosphere, and that’s tech blogs. But engineering isn’t just “tech companies”, which in modern parlance seems to really just mean computer and Internet companies. (I’ve somewhat ranted about this before in the last two paragraphs of this post.) A lot of stuff also goes on in physical infrastructure that engineers could talk about. And in an era where the Internet seems increasingly interested in discussion of how system shapes our lives, it seems like we’re missing out if the people who help shape physical systems don’t share their voices.

Edit to add: I also realize I didn’t include any discussion about Twitter here, mainly because I’m still a novice there. But I still haven’t seen very long discussions on specific engineering issues on Twitter, though I assume tech is the exception again.

Quick Thoughts on Diversity in Physics

Earlier this month, during oral arguments for Fisher v. University of Texas, Chief Justice John Roberts asked what perspective an African-American student would offer in physics classrooms. The group Equity and Inclusion in Physics and Astronomy has written an open letter about why this line of questioning may miss the point about diversity in the classroom. But it also seems worth pointing out why culture does matter in physics (and science more broadly).

So nature is nature and people can develop theoretical understanding of it anywhere and it should be similar (I think. This is actually glossing over what I imagine is a deep philosophy of science question.) But nature is also incredibly vast. People approach studies of nature in ways that can reflect their culture. Someone may choose to study a phenomenon because it is one they see often in their lives. Or they may develop an analogy between theory and some aspect of culture that helps them better understand a concept. You can’t wax philosphical about Kekule thinking of ouroboros when he was studying the structure of benzene without admitting that culture has some influence on how people approach science. There are literally entire books and articles about Einstein and Poincare being influenced by sociotechnical issues of late 19th/early 20th century Europe as they developed concepts that would lead to Einstein’s theories of relativity. A physics community that is a monoculture then misses out on other influences and perspectives. So yes, physics should be diverse, and more importantly, physics should be welcoming to all kinds of people.

It’s also worth pointing out this becomes immensely important in engineering and technology, where the problems people choose to study are often immensely influenced by their life experiences. For instance, I have heard people say that India does a great deal of research on speech recognition as a user interface because India still has a large population that cannot read or write, and even then, they may not all use the same language.

2015 in review

Thank you everyone for reading my blog this year! May you all have a Happy New Year!

The stats helper monkeys prepared a 2015 annual report for this blog.

Here’s an excerpt:

A San Francisco cable car holds 60 people. This blog was viewed about 2,100 times in 2015. If it were a cable car, it would take about 35 trips to carry that many people.

Click here to see the complete report.