Medical hypotheses
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Editorial
Mega-prizes in medicine: big cash awards may stimulate useful and rapid therapeutic innovation.
Following Horrobin's suggestion of 1986, I argue that offering very large prizes (tens of millions of US dollars, or more) for solving specific therapeutic problems, would be an excellent strategy for promoting the rapid development of effective new treatments. The two mainstream ways of paying for medical research are funding the process with grants or funding the outcome via patent protection. When grants are used to fund the process of research the result tends to be 'pure' science, guided by intrinsic scientific objectives. ⋯ For example, medical charities focused on specific diseases should consider accumulating their resources until they can offer a mega-prize for solving a clinical problem of special concern to their patients. Prize money should be big enough to pay for the research and development, the evaluation of the new treatment in a clinical trial, and with a large profit left-over to compensate for the intrinsic risk of competing. Sufficiently large amounts of money, and the prestige and publicity derived from winning a mega-prize, could rapidly mobilize research efforts to discover a whole range of scientifically un-glamorous but clinically-useful therapeutic breakthroughs.
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The mid-20th century saw the rise of the boy-genius, probably because a personality type characterized by prolonged youthfulness is advantageous both in science and modern life generally. This is the evolution of 'psychological neoteny', in which ever-more people retain for ever-longer the characteristic behaviours and attitudes of earlier developmental stages. Whereas traditional societies are characterized by initiation ceremonies marking the advent of adulthood, these have now dwindled and disappeared. ⋯ Since modern cultures favour cognitive flexibility, 'immature' people tend to thrive and succeed, and have set the tone of contemporary life: the greatest praise of an elderly person is to state that they retain the characteristics of youth. But the faults of youth are retained with well as its virtues: short attention span, sensation- and novelty-seeking, short cycles of arbitrary fashion and a sense of cultural shallowness. Nonetheless, as health gets better and cosmetic technologies improve, future humans may become somewhat like an axolotl - the cave-dwelling salamander which retains its larval form until death.