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Considering requests for compassionate use of experimental drugs remains one of the hardest, most complex tasks that any health-care company faces, as Helen Ouyang writes [“Hashtag Prescription,” Essay, June]. Patients make these requests when they are at their most vulnerable — when they have not responded to available treatments or are not eligible for clinical trials. In an effort to create a fair and transparent process for evaluating compassionate-use requests, Janssen/Johnson & Johnson launched an innovative collaboration with the Division of Medical Ethics at the NYU School of Medicine, which has been at the forefront of the conversation about compassionate use. Together, we set up an advisory committee of internationally recognized medical experts, bioethicists, and, most important, patient representatives. This panel of independent external advisers ensures that each patient’s request is evaluated according to objective criteria and high ethical standards.

Amrit Ray
Chief Medical Officer, Janssen
Titusville, N.J.

Arthur Caplan
Director, Division of Medical Ethics NYU School of Medicine
New York City

With the help of our compassionate-use campaign, Josh Hardy received an experimental drug that saved his life, but the episode also motivated me and other patient advocates — along with Congress, the Food and Drug Administration, health-care providers, and ethicists — to reexamine the process through which experimental drugs are given to terminally ill patients.

Desperate parents will pursue any means to save the lives of their children. The publicity surrounding the success of the Josh Hardy campaign gave these parents what I would characterize as false hope — since there is no guarantee that experimental drugs will work and typically no data available on their historical success rates in children with cancer. Children who take these drugs may experience severe and painful side effects that one pediatric oncologist has described as “torture.”

So what’s the solution? We must work with the FDA and drug companies to accelerate the pace of clinical trials for children. Currently, trials for children with cancer lag many years behind those for adults, even though there’s often no scientific or medical reason to bar children from participating. If the FDA and its industry partners worked as hard to improve the clinical pathway as they are currently working to streamline the compassionate-use process, sick children and their families would be much better off.

Richard L. Plotkin
Cofounder and Vice Chairman, Max Cure Foundation
Englewood Cliffs, N.J.

Trading Up

Paul Wood seems to believe that Donald Trump’s supporters are exclusively bitter, xenophobic, undereducated carnival workers [“Trump’s People,” Report, June]. If he shifted his focus from Trump’s bad taste — a reality, but a trifling one — to Trump’s proposed policies, he might come to a different conclusion.

For a generation, left-leaning Americans like me have been betrayed by a stream of politicians claiming to act in our name. One example offers an interesting window on Trump’s appeal. In 1999 the Clinton Administration brokered a landmark deal that led to China becoming a permanent member of the World Trade Organization, despite widespread international concern about the country’s atrocious record of human-rights abuses. The deal came as no great surprise to those of us who paid attention to the campaign-finance controversy of 1996, in which China had been strongly implicated in an attempt to influence U.S. foreign policy.

More than 50,000 U.S. factories have closed and millions of jobs have moved overseas in the years since the agreement was reached. Our trade deficit has soared, and the erosion of the manufacturing sector has been the principal driver of the disappearance of the middle class. All of this thanks to the supposedly liberal policies of the Clinton Administration.

We finally have a candidate willing to speak out against these trade deals, one who — for all his nouveau riche gaucheness — does not seem so easily bought by foreign interests. Please do forgive me if I overlook Trump’s bad hair and moments of boorish populism; I’m more concerned with human dignity, the well-being of my countrymen, and the imperiled world we inhabit.

Michael Boisson
Marfa, Tex.


Because of an editing error, the caption for Findings [June] misstated the location of the museum where Yun-Fei Ji’s Blind Stream was on view. The Ruth and Elmer Wellin Museum of Art is located at Hamilton College, in Clinton, N.Y., not in Hamilton, N.Y. We regret the error.

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August 2016

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