Brownstone Journal

By Peter C. Gøtzsche at Brownstone dot org. The Cochrane Collaboration publishes systematic reviews of the effects of healthcare interventions. I was one of the founders but was expelled 25 years later, in September 2018, becoming the only person ever to be expelled. Cochrane's actions were widely condemned in top journals, e.g. in Science, Nature, The Lancet, and in the BMJ whose Editor-in-Chief wrote that Cochrane should be committed to holding industry and academia to account, and that my expulsion reflected "a deep seated difference of opinion about how close to industry is too close." The world's most cited medical researcher, Professor John Ioannidis from Stanford, published a scathing criticism of Cochrane's "character assassination" of me, wondering if Cochrane had silenced "a giant with major positive contributions to evidence-based medicine" because it had been hijacked. I published two books about the affair and a book review noted: "This book carefully recounts this dark period in medical science where a once-trusted institution carried out one of the worst show trials ever conducted in academia. The CEO and his collaborators went about their task in a manner that mirrors how the drug industry operates." Cochrane's downfall started in 2012, when British journalist Mark Wilson became the CEO. To the dismay of the Cochrane pioneers, he directed the prestigious Cochrane Titanic towards the iceberg that would sink us all, in the same way as he seems to have also destroyed his former workplace, Panos in London. I tried to prevent this and was elected to the Governing Board in January 2017 with the most votes even though I was the only one of the 11 candidates who criticised the leadership in my election statement. When I became a threat to Wilson, he plotted my demise. He was in total control of the Governing Board, and in a Kafkaesque process, he and the board's two co-chairs, Martin Burton and Marguerite Koster, broke all the essential rules for charities and for Cochrane and lied to defend their actions. Burton, who, like so many others, was afraid of Wilson, who was his boss, was the executioner. Wilson's plot involved that Burton should compile a report to a lawyer hired by Cochrane, a so-called Counsel, about my alleged wrongdoings during my 25 years with Cochrane, and that the board should use Counsel's report to expel me. But there was a problem. Counsel's report exonerated me. He saw no reason to discipline me, which is remarkable because Burton, in his report to Counsel, had lied blatantly. He even called it an "allegation" that several board members witnessed that Wilson totally lost his temper during a board meeting and became physically aggressive toward a board member. The Secret Show Trial I was given only 5 minutes to defend myself before I was asked to leave the board room. I was therefore unable to correct misunderstandings and falsehoods raised against me during the rest of the day. However, I had ensured, according to our rules, that the meeting - which was planned to be top secret and unrecorded - was recorded, and a board member gave me a copy of his recordings, even though Wilson had asked everyone to delete them. They revealed that Burton and Koster had lied to convince the board to expel me. Burton talked about long-term disruptive, outrageous, and wrong behaviour, failure to abide by the rules and behave collaboratively, and breaches of the Collaboration Agreement, all of which were untrue. He also hinted that I had harassed Cochrane staff sexually: "To carry on the Me-Too analogy…" and claimed that my "allegations," which were proven facts, about his own and Wilson's mismanagement of Cochrane had been demonstrated to be wrong." Burton used "evidence" he had planted himself, - letters of complaint about me that curiously all arrived just after I had submitted my report to Counsel documenting Burton's maladministration of Cochrane and how he and a previous co-chair, Lisa Bero, had tampered wi...

By Eyal Shahar at Brownstone dot org. Dear Editor: In an ideal world of uncensored Covid science, I would have submitted this letter through the online submission website. However, my experience in 2021 and 2022 and more recently has taught me that there was zero chance that you would have published this text.It has been over four years since the following letter to the editor was published in your journal, but I discovered it only last month. I think there is no expiration date for the search for the truth, and I hope you agree. Relying on data from 280 nursing homes across 21 states, the authors concluded: "These findings show the real-world effectiveness of the mRNA vaccines in reducing the incidence of asymptomatic and symptomatic SARS-CoV-2 infections in a vulnerable nursing home population." That is far from the truth. First, they did not report a single estimate of effect, such as a risk (probability) ratio. That the authors conclude "real-world effectiveness" without showing any estimate is astonishing. It is also astonishing that peer-reviewers or the editorial board have allowed that to happen. Second, in every nursing home an unvaccinated resident was followed at least three weeks longer than a fully vaccinated resident, so their risk (probability) of infection was higher. Time at risk was neither reported nor considered. Third, a key risk ratio I will shortly compute from the data is confounded by time trends in the background risk of an infection. Fourth, comparing the risk ratio of infection (mucosal immunity) with the risk ratio of symptoms if infected (systemic immunity), we observe implausible results. Lastly, a rudimentary correction suggests near-zero effectiveness of two doses of an mRNA vaccine in this population. To set the record straight, I offer a peer review of the study and show several risk ratios. The first dose of an mRNA vaccine was administered on December 18, 2020. Follow-up of nursing home residents who received two doses began at least 21 days later, on January 8, and lasted till March 31. The timeline is shown in the figure along with the epidemic curve. Unvaccinated residents "were present at their facility on the day of the first vaccination clinic" (i.e., at the time of the first dose, if administered by February 15) and were not vaccinated by March 31. Therefore, in every facility, the follow-up time of unvaccinated residents was three weeks longer if the second dose was the Pfizer vaccine and four weeks longer if it was Moderna. Moreover, follow-up of unvaccinated residents in some nursing homes started between December 18 and January 8. Not only was it earlier, but that was a period of high risk of infection just before the peak of the winter wave (see figure). All two-dose recipients were spared that early, high-risk exposure time. This bias-confounding by time trends in the background risk-has operated in other "real-world" studies from that time. The bias is worse if the follow-up is delayed until 14 days after the second dose (to allow full immunity). In this case, follow-up of recipients of two doses began on January 22, ten days after the peak. Using data from Table 1 in the letter, I computed three risk ratios (RR). In every facility, day 0 for the unvaccinated was 3-4 weeks earlier than day 0 for two-dose recipients. The key number is the risk ratio of symptomatic infection. It is 0.1 (90% vaccine effectiveness). Surprisingly, the mRNA vaccines seem to have offered fragile residents of nursing homes with a weakened immune response almost the same level of protection that was reported for younger, healthy populations. Remarkable if true, or difficult to believe. The risk ratio of symptomatic infection, which I questioned, is the product of two risk ratios: the risk ratio of infection (0.19) times the risk ratio of symptoms if infected (0.52). The first estimate is unquestionably implausible. Upper respiratory infection is primarily prevented by secretory IgA antibodies on ...

By Joaquim Couto at Brownstone dot org. There was a time when debates about determinism and free will belonged to philosophy departments and late-night dorm room conversations. They were enjoyable precisely because they seemed harmless. Whatever the answer, life went on. Courts judged, doctors decided, teachers taught, and politicians were still-at least nominally-held responsible for their actions. That era is over. Artificial intelligence has transformed what once appeared to be an abstract philosophical question into a concrete issue of governance, power, and accountability. Determinism is no longer merely a theory about how the universe works. It is becoming an operating principle for modern institutions. And that changes everything. AI systems are deterministic by construction. They operate through statistical inference, optimization, and probability. Even when their outputs surprise us, they remain bound by mathematical constraints. Nothing in these systems resembles judgment, interpretation, or understanding in the human sense. AI does not deliberate. It does not reflect. It does not bear responsibility for outcomes. Yet increasingly, its outputs are treated not as tools, but as decisions. This is the quiet revolution of our time. The appeal is obvious. Institutions have always struggled with human variability. People are inconsistent, emotional, slow, and sometimes disobedient. Bureaucracies prefer predictability, and algorithms promise exactly that: standardized decisions at scale, immune to fatigue and dissent. In healthcare, algorithms promise more efficient triage. In finance, better risk assessment. In education, objective evaluation. In public policy, "evidence-based" governance. In content moderation, neutrality. Who could object to systems that claim to remove bias and optimize outcomes? But beneath this promise lies a fundamental confusion. Prediction is not judgment. Optimization is not wisdom. Consistency is not legitimacy. Human decision-making has never been purely computational. It is interpretive by nature. People weigh context, meaning, consequence, and moral intuition. They draw on memory, experience, and a sense-however imperfect-of responsibility for what follows. This is precisely what institutions find inconvenient. Human judgment introduces friction. It requires explanation. It exposes decision-makers to blame. Deterministic systems, by contrast, offer something far more attractive: decisions without decision-makers. When an algorithm denies a loan, flags a citizen, deprioritizes a patient, or suppresses speech, no one appears responsible. The system did it. The data spoke. The model decided. Determinism becomes a bureaucratic alibi. Technology has always shaped institutions, but until recently it mostly extended human agency. Calculators assisted reasoning. Spreadsheets clarified trade-offs. Even early software left humans visibly in control. AI changes that relationship. Systems designed to predict are now positioned to decide. Probabilities harden into policies. Risk scores become verdicts. Recommendations quietly turn into mandates. Once embedded, these systems are difficult to challenge. After all, who argues with "The science?" This is why the old philosophical debate has become urgent. Classical determinism was a claim about causality: given enough information, the future could be predicted. Today, determinism is turning into a governance philosophy. If outcomes can be predicted well enough, institutions ask, why allow discretion at all? Non-determinism is often caricatured as chaos. But properly understood, it is neither randomness nor irrationality. It is the space where interpretation occurs, where values are weighed, and where responsibility attaches to a person rather than a process. Remove that space, and decision-making does not become more rational. It becomes unaccountable. The real danger of AI is not runaway intelligence or sentient machines. It is the slow erosion of human re...

By Roger Bate at Brownstone dot org. Argentina's government has become increasingly skeptical of the World Health Organization, reflecting a wider reconsideration of international health institutions in the aftermath of Covid-19. Although Argentina has not formally withdrawn, it has expressed dissatisfaction with the WHO's performance, its growing reliance on donor-funded agendas, and its push for expanded treaty authority. This reassessment coincides with the even more consequential reality that the United States has initiated its withdrawal from the WHO. It is the first time since the Soviet Union rejoined the WHO in the 1950s that a major funder, in this case its most influential member, has stepped away. The US departure changes the strategic environment in which Argentina must act. Washington's decision was driven by concerns that the WHO mishandled the pandemic, promoted extreme and damaging restrictions, tolerated poor scientific practice, and allowed private philanthropies and advocacy networks to shape policy. The United States may seek reentry if future negotiations produce meaningful reform, and it may rejoin under a future administration, but for the foreseeable future the WHO will operate without its principal sponsor. This shift presents Argentina with new risks and new opportunities. Argentina could leave immediately, but doing so now would limit its influence. Remaining as a conditional participant offers a more effective path. Conditional engagement means Argentina stays within the WHO while making clear that its membership depends on substantial changes in governance, transparency, and scientific integrity. This approach preserves access to certain technical networks, avoids needless diplomatic friction, and allows Argentina to align its stance with that of the United States during a period of global institutional realignment. Just as importantly, it leaves withdrawal as an option if the WHO remains unresponsive. The case for this strategy rests on well-documented failures. During Covid-19, the WHO endorsed restrictive measures that imposed severe economic and health and social costs, particularly in low- and middle-income countries (LMICs). It resisted acknowledging successful alternative strategies, notably in Sweden and Tanzania, and later revised its historical guidance in ways that shielded institutional authority rather than enabling honest evaluation. In tobacco control and other areas, the WHO has become increasingly shaped by donor priorities that do not reflect the interests of sovereign nations. The well-intentioned initiatives to limit the harms from smoking have led to unintended and perverse consequences that the organization has been reticent in acknowledging. The proposed expansion of the International Health Regulations and the Pandemic Agreement-negotiated with limited transparency-would grant the organization unprecedented influence over national emergency responses. These dynamics undermine trust and justify Argentina's insistence on reform. Conditional engagement allows Argentina to use its membership to demand these reforms. It can press for transparency in donor funding, scientific pluralism in decision-making, strict limits on the WHO's authority during emergencies, and priority attention and resources to the most lethal infectious diseases in the LMICs. It can refuse to implement WHO recommendations unless they pass independent national review. With the United States now outside the WHO, Argentina becomes one of the few reform-minded voices still at the table, giving it a degree of influence it would not have from the outside. Should meaningful reforms fail to materialize, Argentina can still withdraw later-and that withdrawal would carry more weight because it followed a period of principled engagement. At the same time, Argentina should deepen bilateral and regional cooperation, especially with the United States, which is building alternative health partnerships to replace WHO me...

By Jeffrey A. Tucker at Brownstone dot org. Among the many incredible revelations over the past five years is the extent of the power of the pharmaceutical companies. Through advertising, they have been able to shape media content. That in turn has affected digital content companies, which responded from 2020 onward by taking down posts that questioned the safety and efficacy of Covid vaccines. They have captured universities and medical journals with donations and other forms of financial control. Finally, they are far more decisive in driving the agenda of governments than we ever knew. Just for example, we found out in 2023 that the NIH shared thousands of patents with pharma, with a market value approaching $1-2 billion. This was all made possible by the Bayh-Dole Act of 1980, which was pushed as a form of privatization but only ended up entrenching the worst corporatist corruptions. The hold over governments was cemented with the National Childhood Vaccine Injury Act of 1986, which granted a liability shield to the makers of products that appear on the childhood schedule. The injured are simply not permitted to fight it out in civilian courts. No other industry enjoys such sweeping indemnification under the law. Pharma today arguably competes with the military munitions industry in its hold over power. No other industry in human history has managed to close the economies of 194 countries to force most of the world's population to wait for its inoculation. Such power makes the East India Company, against which the American founders revolted, look like a corner grocery by comparison. There is ample talk about how much pharma has suffered since its vaunted product flopped. But let's not be naive. Their power is still ubiquitously on display in every sector of society. The fight at the state level for over-the-counter therapeutics - and for medical freedom for the citizenry - reveals the scope of the challenges ahead. The reformers that now head agencies in Washington are fighting daily through a thicket of influence that goes back many decades. Just how far in the past does this power extend? The first federal effort to push vaccination - however primitive and dangerous - was from President James Madison. "The Act to Encourage Vaccination" of 1813 required that smallpox vaccines be given away for free and properly delivered to anyone who requests them. As injury and death piled up, and amidst cries of profiteering and corruption, Congress acted decisively in 1822 to repeal the act. The turning point in public opinion was what came to be known as the Tarboro Tragedy. The most reputed vaccinologist in the country and the official guardian of the vaccine, Dr. James Smith, had accidentally sent material containing live smallpox virus instead of cowpox vaccine to a physician in Tarboro, North Carolina. This caused a local smallpox outbreak, infecting around 60 people and resulting in approximately 10 deaths. This error damaged public and Congressional trust in the federal program's ability to safely handle and distribute vaccine matter. The great promise of vaccination, which seemed to raise the possibility of the scientific eradication of deadly disease under the guidance of elite healers, had fallen into disrepute. Even so, when the Civil War broke out in 1861, there was a push to get all soldiers vaccinated to stop deadly smallpox outbreaks. With that came a slew of injuries and deaths. Historian Terry Reimer writes: "Unfavorable results from vaccination, or spurious vaccinations, were all too common. Even pure vaccine, obtained from official Army dispensaries, sometimes caused complications. Sometimes, faulty preservation of the crusts could have compromised their effectiveness. As is the case even with modern vaccines today, occasionally, the vaccine did not take, failing to produce the major reaction at the vaccination site that was expected. In other cases, the site of the vaccination became overly sore and swollen, and...

By Eric Hussey at Brownstone dot org. In the theatrical musical version of Peter Pan, Peter leads the Neverland children in a song about (not) growing up. Toward the end of the song, Peter and the kids sing "We won't grow up! We will never grow a day! And if someone tries to make us…we will simply run away." That strikes me as not wildly different from the attitudes of many Americans about "health care." Although, it's not about "health care" as such, it's about billing: who will pay for doctor visits, hospital visits, and medications. I suffered through a local professional association meeting not long ago and had to listen to a state senator talk about how his foremost goal legislatively is to assure "access" to "health care" for all in the State of Washington. He also let slip that Washington State is the "most highly leveraged" state in the Union for "health care." Then he went on to bemoan that the State of Washington doesn't have its own printing press to make money like the federal government does. If you will allow me to do what some might call a "pirate translation" of the above, let me suggest that Washington State - I usually call it The People's Republic of Washington State - borrows more money per capita than any other state in the Union, from a federal government $37+ trillion in debt, to pay for doctor visits, hospital visits, and medications for whoever asks. The state bureaucracy to oversee this is paid for by ever-increasing taxes on the state population. "Access" is not the correct word. Payment is the correct word. Well, actually, freedom from payment is the correct term. Sometimes I hear a soon-to-become-former patient of mine - occasionally an already-former patient of mine - tell me how they hate it, but they can't come to see me any more since I don't take their insurance. No, that's incorrect. I assure you, you can come see me. But, because your insurance is a big pain in the neck for a single-doctor office like mine, I will not do the paperwork and take the discounts that they require to get any pay for my work. In fact, I will be happy to see you in my office. But, you will need to tell us how you will be paying for the visit. To add some perspective to that, my independent one-doctor office has one-and-one-half full time people primarily billing insurance companies. Although three or four companies are involved, the majority of people in the State of Washington have some form of insurance through the State via one of those companies. That is, people who would never admit to this openly or even to themselves, are essentially on welfare with the State of Washington borrowing, keeping their insurance payments lower than they should be. Which brings me back to Peter Pan. I don't have any particularly embarrassing instances to share, but I have some vague recollections of my mother saying "Grow up!" after an errant behavior of mine. A great deal of growing up means you are taking responsibility for yourself and your actions. Does that include paying your way? If you are paying your way, you need to know how much something costs. When you are on welfare, that becomes irrelevant. Ben Carson famously suggested his remedy for the "health care crisis" in 2013 at the National Prayer Breakfast. It took 43 seconds to deliver: "We've already started down the path to solving one of the other big problems, health care. We need to have good health care for everybody. It's the most important thing that a person can have. Money means nothing. Titles mean nothing when you don't have your health. But we've got to figure out efficient ways to do it. We spend a lot of money on health care, twice as much per capita as anybody else in the world, and yet not very efficient. What can we do? Here's my solution: When a person is born, give him a birth certificate, an electronic medical record, and a health savings account [HSA] to which money can be contributed, pre-tax, from the time you are born to the time you die. When y...

By Joseph Varon at Brownstone dot org. Introduction In the past, medical judgment was underpinned by three fundamental pillars: honest observation, open debate, and the humility to acknowledge our limitations in knowledge. While these principles still thrive in the day-to-day interactions within clinics and ICU corridors, they have been increasingly overshadowed online by a chaotic environment that often prioritizes sensationalism over substance. Social media has radically transformed not only the means of communication but also the very fabric of our daily lives. It has reshaped how we think, how we evaluate information, and whom we choose to trust. Instead of fostering informed dialogue, it has turned medical science into a contentious battleground where opinions clash and algorithms amplify the most extreme and polarizing voices, often sidelining more measured perspectives. Yet, amid the cacophony, there are invaluable elements that have emerged. Like medicine itself, social media encompasses a spectrum of experiences: the good, the bad, and the ugly. The Good: Knowledge Finally Reached Everyone James Madison eloquently asserted that a free society must arm itself with the power that knowledge provides. Social media has, in many ways, fulfilled this imperative, democratizing information in unprecedented ways. Patients with rare diseases, who once felt isolated in their suffering, can now connect with one another through forums and support groups. They share personal experiences, collaborate on finding solutions, and gain insights faster than many traditional healthcare institutions can publish. On a global scale, physicians are able to consult with one another, sharing clinical patterns and treatment responses in real time, facilitating discussions that transcend geographical boundaries-something no medical journal could match in terms of speed. During public health crises, the speed of information sharing on social media became even more critical. Frontline doctors were able to alert their colleagues around the world, share early observations about disease patterns, and identify trends long before official guidelines could catch up. This rapid exchange of information became a lifeline for both patients and clinicians, providing critical support and empowering individuals in ways that were previously inconceivable. This aspect of social media, fostering connection and knowledge sharing, is something we must strive to uphold and protect. The Bad: Expertise Collapsed Under the Weight of Noise George Washington recognized that truth prevails only when individuals are willing to work diligently to uncover it. Unfortunately, this principle has been undermined in the social media landscape, which now rewards speed, outrage, and unfounded certainty. These attributes are fundamentally incompatible with the rigorous, evidence-based approaches that underpin the practice of medicine. In an era where every voice can be amplified, the lines separating informed medical professionals from those devoid of scientific understanding have blurred significantly. Individuals lacking formal training can present themselves as experts, and the public often struggles to make informed distinctions. Confidence can resemble knowledge, and performance can be mistaken for credibility. This phenomenon has created a chilling effect, even on qualified clinicians who may hesitate to express their viewpoints openly. They do so not because they lack evidence or expertise, but because they fear retribution from a vocal online mob. A single misinterpreted statement can lead to harassment, damage to professional reputations, or even formal complaints. In a climate where dissenting voices are often silenced, many choose to remain silent-believing it safer than risking honesty. Such dynamics are detrimental to the field of medicine, where healthy scientific discourse and a willingness to engage in constructive disagreement are essential for progress. The Ugly: C...

By Russ Gonnering at Brownstone dot org. What is the relationship between education, knowledge, and wisdom? This is not a trivial question, and the ramifications are far from obvious. Our lives may literally depend on it. Let me illustrate the problem. On 12/5/2025, a Joint Statement from numerous medical organizations was released, highly critical of the recent recommendation of the Advisory Committee on Immunization Practices (ACIP) of the Centers for Disease Control and Prevention (CDC) on modification of universal administration of the Hepatitis B vaccine to every newborn. The wording of the statement is telling: "We are deeply alarmed by the actions taken this week by the Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices (ACIP). The apparent goal of this meeting was to sow doubt in vaccines rather than advance sound vaccine policy, and we will all pay a price for that. "This is a significant departure from the historic role ACIP has played in shaping vaccine policy in the United States. Previously, we could expect science to drive decisions, experts to debate evidence, and consensus to lead to shared, clear recommendations. That is not the case with the current committee, and this change puts Americans' health at risk. (emphasis added) This is like the statement from the National Foundation for Infectious Diseases from June 27, 2025, regarding the current makeup of the ACIP: Deviation from the long-standing evidence-based process that has historically guided ACIP deliberations undermines transparency and trust, risks legitimizing misinformation, and is harmful to public health. A process that includes input from Centers for Disease Control and Prevention (CDC) experts, working groups, and trusted scientific and medical organizations, has been critical to ensuring rigorous, transparent, evidence-based recommendations that the public and healthcare professionals can trust. Voting on critical policy recommendations without due process that includes a thorough, balanced, and vetted review of available data by qualified experts invalidates the results and leads to confusion and distrust of recommendations. On 12/14/2025 Politico published a piece entitled This vaccine adviser to RFK Jr. has some choice words for his critics. It reviewed the firestorm of criticism being leveled at the current members of the ACIP of the CDC as well as the response from Retsef Levi, including: I think we've adopted an extremely medicalized view of health. Our system is very centralized and coercive. Too many public-health policies assume that a small group at the top should make decisions for everyone and enforce them instead of putting the individual at the center and empowering people, with the support of doctors and others, to take ownership of their health. Some ACIP members and presenters are criticized as not appropriate for the ACIP because they are not physicians or "experts." My view is quite different, and I agree with Professor Levi. They are terrific choices, not despite not being physician "experts," but because of it! And I will back this up with clear evidence. The problem has to do with entrained thinking in both leaders and experts. When both are combined in decision-makers, so is the danger as explained by David Snowden and Mary Boone in A Leaders Framework for Decision Making: …leaders are susceptible to entrained thinking,a conditioned response that occurs when people are blinded to new ways of thinking by the perspectives they acquired through past experience, training, and success… Entrained thinking is a danger in complicated contexts, too, but it is the experts (rather than the leaders) who are prone to it, and they tend to dominate the domain. When this problem occurs, innovative suggestions by nonexperts may be overlooked or dismissed, resulting in lost opportunities. The experts have, after all, invested in building their knowledge, and they are unlikely to tolerate controversi...

By Daniel Nuccio at Brownstone dot org. Earlier this month, after roughly a 20-year wait, audiences finally had the opportunity to see Quentin Tarantino's Kill Bill: The Whole Bloody Affair. Initially released in 2003 and 2004, Kill Bill: Volumes 1 and 2 comprised Tarantino's then long-awaited fourth film, originally envisioned by the auteur as a single work but later split by producer Harvey Weinstein to avoid either releasing a movie with an over four-hour run-time that might deter the casual moviegoer or a greatly pared version that would severely compromise Tarantino's vision. Hence, Volume 1 introduced viewers to "The Bride," a young, female, assassin, beaten, gunned down, and left for dead on the day of her wedding (or, more accurately, wedding rehearsal) by the Deadly Viper Assassination Squad, the team of trained killers led by the titular Bill, The Bride's former lover and father to her unborn child. In Volume 1 we see The Bride awaken from a coma after several years and win a knife fight against one of her former co-workers. Yet, the bulk of the volume focuses on The Bride's acquisition of a legendary Hattori Hanzō sword and the series of stylized battles she must overcome before facing O-Ren Ishii, a former teammate who has ascended to the head of the Tokyo yakuza. Slower and more methodical, Volume 2 better develops the remaining characters, further exploring their backstories and relationships with one another while gradually building towards The Bride's final confrontation with Bill, which manages to both subvert and exceed expectations. Although both volumes can be viewed as individual masterpieces, for Millennial cinephiles a single film called Kill Bill came to be viewed as something like the original theatrical release of George Lucas' Star Wars. Unlike the four-hour cut of David Lynch's Blue Velvet or the lost pie fight scene from Stanley Kubrick's Dr. Strangelove, it was known to still exist. Tarantino had screened it in 2006 at Cannes and again for a special showing in 2011. He just wasn't releasing it for general audiences. Then finally on December 5, 2025, Kill Bill: The Whole Bloody Affair, quietly hit theaters, taking the number six spot for its opening weekend - something pretty impressive for a largely unadvertised four hour and thirty-five minute remix of a pair of films from more than 20 years ago. When I learned of its release by chance while checking the movie listings for my local AMC, I promptly cleared an evening to ensure I could experience Kill Bill as intended. And, I am glad I did. On whatever level, the experience is different watching the film as a single whole in a single sitting as opposed to watching it as two separate films months apart. Moreover, it was also a reminder of what movies used to be - and still could be. Every scene is expertly crafted. Every shot is perfectly framed. Every color is carefully chosen. Every line of dialogue, no matter how seemingly insignificant, reveals something about the characters and their relationships with one another. The construction of the narrative is a masterclass in storytelling. Moreover, after more than twenty years, watching The Bride embark on her globe-trotting, blood-soaked quest for revenge was just as captivating as it ever was. Watching her battle through O-Ren Ishii's henchmen at the House of Blue Leaves was no less exciting. Watching her training under the mystical Pai Mei pay off as she punches her way out of her grave was no less triumphant. Watching her final confrontation with Bill was no less suspenseful. Yet, throughout the film, I could not help but be troubled by a couple of nagging thoughts no matter how much I tried to cast them aside. They Just Don't Make Them Like They Used to The first nagging thought, to which I already alluded, was that movies really have changed since 2004, undoubtedly for the worst. It seems strange thinking about Kill Bill in 2025 the way people did about Lawrence of Arabia or The Godfather in ...

By Peter C. Gøtzsche at Brownstone dot org. fiction or faith. It is a major failure to give equal prominence to people presenting scientific facts and people talking about their feelings or beliefs with no evidence in their support, or to allow them to contradict unchallenged the most reliable evidence we have. However, virtually every time I know something about a healthcare issue considered controversial, this is what I see in the news, and the hepatitis B vaccine controversy illustrates this abundantly. On 5 December 2025, with a vote of 8 versus 3, the Advisory Committee on Immunization Practices (ACIP) at the Centers for Disease Control and Prevention (CDC) ended the recommendation that all newborns in the United States receive a hepatitis B shot at birth. The birth dose was recommended only if the mother had tested positive for the virus or if her infection status was unknown. The change was very rational, and as in Western Europe, only Portugal recommends a universal birth dose, it would seem difficult to argue against it. But the media did and failed us badly. Two days after the vote, I downloaded news stories from 14 major media outlets, and they were all very negative. The media used three main tactics to support their beliefs: They denigrated the Secretary of Health, Robert F. Kennedy, Jr., the members of ACIP he had selected, and some of the presenters at the meeting. They gave undue prominence and praise to the three dissenting ACIP voices and outsiders, who were depicted as experts or scientists, as if to say that they must be right, and they were widely quoted for their remarks, which were rarely rational or evidence-based. They didn't check if what the critics of the policy change claimed was correct. The Denigration of Kennedy Of the 14 news outlets, only Nature did not denigrate Kennedy. Reuters started its press release by saying it was "a major policy win" for Kennedy that vaccine advisers named by him reversed a decades-long recommendation "that disease experts say will reverse decades of public health gains." So, Kennedy's advisers were not experts, and as the critics were experts, they must be correct, right? Reuters noted that the CDC is "now run by a Kennedy-appointed acting head, Jim O'Neill, who is not a scientist;" that Kennedy founded the anti-vaccine group Children's Health Defense; fired ACIP's previous 17 "independent" experts and replaced them with a group that largely supports his views; dropped broad recommendations for the Covid vaccine and cut funding for mRNA vaccines. The facts are that several of the previous experts at the ACIP were not independent but had conflicts of interest in relation to vaccine manufacturers and other drug companies; that recommending Covid vaccines only to high-risk groups brought the US on par with Europe; and that cutting funding for mRNA vaccine research was well motivated. Kennedy said that his team had reviewed the science and found that these vaccines fail to protect effectively against upper respiratory infections like Covid and flu. His department was therefore shifting the funding toward "safer, broader vaccine platforms that remain effective even as viruses mutate." Reuters misrepresented the ACIP meeting entirely, claiming that "many of Kennedy's committee members criticized the vaccine as unsafe." What they said was that safety had not been adequately studied, which was correct. The other media called Kennedy a vaccine sceptic (The Hill, Health Policy Watch, CBC), a vaccine activist (CNN, the Guardian), or an anti-vaccine advocate (PBS), who fired all 17 previous members of the ACIP, replacing them with people who largely shared his scepticism (New York Times, Washington Post, National Public Radio, CNN, PBS, CBS News, Time, Health Policy Watch, CBC, BBC, the Guardian) with a "goal of upending vaccine policy" (New York Times), and the vote fulfilled a long-held goal of the anti-vaccine movement (The Hill). The CBC, the largest news broadcaster in C...

By Roger Bate at Brownstone dot org. Every morning, hundreds of millions of people perform a socially approved ritual. They line up for coffee. They joke about not being functional without caffeine. They openly acknowledge dependence and even celebrate it. No one calls this addiction degenerate. It is framed as productivity, taste, wellness-sometimes even virtue. Now imagine the same professional discreetly using a nicotine pouch before a meeting. The reaction is very different. This is treated as a vice, something vaguely shameful, associated with weakness, poor judgment, or public health risk. From a scientific perspective, this distinction makes little sense. Caffeine and nicotine are both mild psychoactive stimulants. Both are plant-derived alkaloids. Both increase alertness and concentration. Both produce dependence. Neither is a carcinogen. Neither causes the diseases historically associated with smoking. Yet one has become the world's most acceptable addiction, while the other remains morally polluted even in its safest, non-combustible forms. This divergence has almost nothing to do with biology. It has everything to do with history, class, marketing, and a failure of modern public health to distinguish molecules from mechanisms. Two Stimulants, One Misunderstanding Nicotine acts on nicotinic acetylcholine receptors, mimicking a neurotransmitter the brain already uses to regulate attention and learning. At low doses, it improves focus and mood. At higher doses, it causes nausea and dizziness-self-limiting effects that discourage excess. Nicotine is not carcinogenic and does not cause lung disease. Caffeine works differently, blocking adenosine receptors that signal fatigue. The result is wakefulness and alertness. Like nicotine, caffeine indirectly affects dopamine, which is why people rely on it daily. Like nicotine, it produces tolerance and withdrawal. Headaches, fatigue, and irritability are routine among regular users who skip their morning dose. Pharmacologically, these substances are peers. The major difference in health outcomes does not come from the molecules themselves but from how they have been delivered. Combustion Was the Killer Smoking kills because burning organic material produces thousands of toxic compounds-tar, carbon monoxide, polycyclic aromatic hydrocarbons, and other carcinogens. Nicotine is present in cigarette smoke, but it is not what causes cancer or emphysema. Combustion is. When nicotine is delivered without combustion-through patches, gum, snus, pouches, or vaping-the toxic burden drops dramatically. This is one of the most robust findings in modern tobacco research. And yet nicotine continues to be treated as if it were the source of smoking's harm. This confusion has shaped decades of policy. How Nicotine Lost Its Reputation For centuries, nicotine was not stigmatized. Indigenous cultures across the Americas used tobacco in religious, medicinal, and diplomatic rituals. In early modern Europe, physicians prescribed it. Pipes, cigars, and snuff were associated with contemplation and leisure. The collapse came with industrialization. The cigarette-rolling machine of the late 19th century transformed nicotine into a mass-market product optimized for rapid pulmonary delivery. Addiction intensified, exposure multiplied, and combustion damage accumulated invisibly for decades. When epidemiology finally linked smoking to lung cancer and heart disease in the mid-20th century, the backlash was inevitable. But the blame was assigned crudely. Nicotine-the named psychoactive component-became the symbol of the harm, even though the damage came from smoke. Once that association formed, it hardened into dogma. How Caffeine Escaped Caffeine followed a very different cultural path. Coffee and tea entered global life through institutions of respectability. Coffeehouses in the Ottoman Empire and Europe became centers of commerce and debate. Tea was woven into domestic ritual, empire, and gentility. Cru...

By Clayton J. Baker, MD at Brownstone dot org. The Third Big Lie of Vaccinology - Insisting My Immunity is Dependent on Your Vaccination - runs contrary to basic logic and rationality. This Big Lie is based on fear-mongering and scapegoating, two of the most irrational and anti-scientific approaches to manipulating human behavior. It is surprising and dismaying that this lie is successfully foisted upon the population so often, but here we are. If My Immunity Depends on Your Vaccination, Then the Vaccine Doesn't Work Disproving this Big Lie is so straightforward that I fear insulting the reader's intelligence by spelling it out step-by-step. Let us do so in the form of a standard syllogism. If: Person A has received a vaccine for a given disease, and The vaccine "worked" - it provided person A with immunity to the disease Then: Another person (Person B) cannot give person A the disease. That's all there is to it. Should I (Person A) insist that you (Person B) are still a threat to infect me with the disease for some reason, for example, that you are unvaccinated, then I am stating that the conclusion of the syllogism is false. If the conclusion is false, then at least one of the premises must be false. If I did in fact get the vaccine, then the first premise is true. In that case, the second premise must be false. In other words, if I get vaccinated and my immunity is still dependent on your vaccination, then the vaccine doesn't work. Period. The Liar's Defense: Moving the Goalposts Now, if I was an intellectually dishonest vaccine zealot (and such people do exist), I very likely would respond to this exposure of my Big Lie by employing a favorite argumentative fallacy of vaccinology: moving the goalposts. Deliberately ignoring the fact that my Big Lie has been disproven, I might deceptively shift the argument in a number of ways. Such tactics were employed again and again during Covid. Perhaps I'd make the pseudoscientific claim that everyone must be vaccinated to achieve the quasi-mythical state of "herd immunity." Never mind that the flawed concept of herd immunity is only even theoretically possible with vaccines that provide "sterilizing" immunity, which the large majority of vaccines do not provide. The Covid vaccines couldn't and didn't provide sterilizing immunity. (Fauci and company knew this from the start, but they still peddled the lie of herd immunity to push for mandatory vaccination against Covid.) Maybe I'd take a totalitarian approach, and insist that your vaccination is a social responsibility to which you must comply, and which you have no right to refuse. This argument violates the 4 Pillars of Medical Ethics, especially the first: Autonomy. It also contradicts fundamental American jurisprudence, as stated by Justice Benjamin Cardozo in 1914: "Every human being of adult years and sound mind has a right to determine what shall be done with his own body." Ultimately, it doesn't matter how often or in where I move the goalposts. The fact remains: if I get vaccinated and my immunity is still dependent on your vaccination, then the vaccine doesn't work. We noted before that the Third Big Lie of Vaccinology is steeped in fear-mongering and scapegoating. Pushing such emotion-based reasons for belief serves a second purpose: it also promotes magical thinking about vaccines. If you are programmed to hold nonsensical, fear-based beliefs about immunity, you can easily be convinced of fantastic, even magical absurdities about public health as well. Magical Thinking and Mass Vaccination Robert F. Kennedy, Jr. was confirmed as US Secretary of Health and Human Services (HHS) on February 13, 2025. An outbreak of measles was declared in West Texas two days later. The Pharma-funded mainstream media quickly attempted to blame the outbreak on Kennedy's confirmation, even though the first reported case had occurred in January. It is absurd to blame Secretary Kennedy's presence at HHS for a measles outbreak beginning prior to...

By Bert Olivier at Brownstone dot org. To some readers it may seem like a rhetorical question to ask whether the narrative of George Orwell's dystopian novel, Nineteen Eighty-Four (or 1984), first published in Britain in 1949, has somehow left its pages and settled, like an ominous miasma, over the contours of social reality. Yet, closer inspection - which means avoiding compromised mainstream news outlets - discloses a disquieting state of affairs. Everywhere we look in Western countries, from the United Kingdom, through Europe to America (and even India, whose 'Orwellian digital ID system' was lavishly praised by British prime minister Keir Starmer recently), what meets the eye is a set of social conditions exhibiting varying stages of precisely the no-longer-fictional totalitarian state depicted by Orwell in 1984. Needless to stress, this constitutes a warning against totalitarianism with its unapologetic manipulation of information and mass surveillance. I am by no means the first person to perceive the ominous contours of Orwell's nightmarish vision taking shape before our very eyes. Back in 2023 Jack Watson did, too, when he wrote (among other things): Thoughtcrime is another of Orwell's conjectures that has come true. When I first read 1984, I would never have thought that this made up word would be taken seriously; nobody should have the right to ask what you are thinking. Obviously, nobody can read your mind and surely you could not be arrested simply for thinking? However, I was dead wrong. A woman was arrested recently for silently praying in her head and, extraordinarily, prosecutors were asked to provide evidence of her 'thoughtcrime.' Needless to say, they did not have any. But knowing that we can now be accused of, essentially, thinking the wrong thoughts is a worrying development. Freedom of speech is already under threat, but this goes beyond free speech. This is about free thought. Everybody should have a right to think what they want, and they should not feel obliged or forced to express certain beliefs or only think certain thoughts. Most people would know that totalitarianism is not a desirable social or political set of circumstances. Even the word sounds ominous, but that is probably only to those who already know what it denotes. I have written on it before, in different contexts, but it is now more relevant than ever. We should remind ourselves what Orwell wrote in that uncannily premonitory novel. Considering the rapidly expanding and intensifying, electronically mediated strategies of surveillance being implemented globally - no doubt aimed at inculcating in citizens a subliminal awareness that privacy is fast becoming but a distant memory - the following excerpt from Orwell's text strikes one as disturbingly prophetic, considering the time it was written (1984, Free Planet e-book, p.5): Behind Winston's back the voice from the telescreen was still babbling away about pig-iron and the overfulfilment of the Ninth Three-Year Plan. The telescreen received and transmitted simultaneously. Any sound that Winston made, above the level of a very low whisper, would be picked up by it, moreover, so long as he remained within the field of vision which the metal plaque commanded, he could be seen as well as heard. There was of course no way of knowing whether you were being watched at any given moment. How often, or on what system, the Thought Police plugged in on any individual wire was guesswork. It was even conceivable that they watched everybody all the time. But at any rate they could plug in your wire whenever they wanted to. You had to live - did live, from habit that became instinct - in the assumption that every sound you made was overheard, and, except in darkness, every movement scrutinized. Before adducing compelling instances of the contemporary, real-world surveillance equivalents of 1984's 'telescreen,' which have become sufficiently 'normal' to be accepted without much in the form of protest, ...

By Clayton J. Baker, MD at Brownstone dot org. When performing scientific studies of the effectiveness and safety of medical treatments, the gold-standard study design is widely considered to be the so-called "prospective, randomized, double-blinded, placebo-controlled clinical trial." While this claim is not universally true for all types of medical investigation, when examining the effectiveness and safety of new - or existing - medical treatments, this rule applies very well indeed. For the purposes of this essay, we will focus on the placebo-controlled aspect of clinical trials. There are two excellent reasons for a clinical trial to be placebo-controlled. First, one does not want to perform a treatment on patients unless the treatment is more effective than leaving them alone. Second, one does not want to perform a treatment on patients if the treatment is more harmful to them than leaving them alone. Unless you are in the vaccine business, that is. The vaccine industry has a long, disgraceful history of shielding the ineffectiveness and toxicity of their products by using false placebos in the clinical trials of their products. What Is a Placebo, and Why Are Placebo-Controlled Studies Important? According to the Merriam-Webster Dictionary a placebo is defined as: 1a: a usually pharmacologically inert preparation prescribed more for the mental relief of the patient than for its actual effect on a disorder b: an inert or innocuous substance used especially in controlled experiments testing the efficacy of another substance (such as a drug) The first definition touches on the famous 'placebo effect,' which is the observed tendency for even inert or 'sham' treatments to produce positive effects in some patients. The second definition is relevant to the clinical trial process. Here, a 'placebo' is the inert treatment that is used in the 'control group' of a clinical trial - that is, the group that doesn't get the active treatment. The control group provides a valid baseline for comparison with the 'treatment group' of the study - that is, the group of subjects that get the actual treatment in question. Note that the placebo must be both inert (inactive) and innocuous (harmless). The reasons for using a true placebo comparison group in a clinical trial are straightforward. By comparing the active therapy under investigation to a true placebo, several vital determinations can be made about the therapy. First, since a true placebo is harmless, one can identify, by comparing harmful effects seen in the group that got the treatment with harmful effects seen in the group that got the placebo, any and all harms caused by the treatment. For example, if a harmful effect is seen equally in both the treatment group and the placebo group of the study, that harmful effect is not attributed to the treatment, but rather to other factors. However, if a harmful effect appears only in the treatment arm of the study (or appears with significantly higher frequency or intensity), it is attributed to the treatment. Second, since a true placebo is inactive, one can determine, by comparing the intended or beneficial effects seen in the treatment group with beneficial effects seen in the placebo, any and all benefits caused by the treatment. For example, if a beneficial effect is seen equally in both the treatment group and the placebo group of the study, that beneficial effect is not attributed to the treatment, but rather to other factors. (In such cases, the beneficial effect seen in the treatment group is often described as 'no better than placebo.') However, if a beneficial effect - especially if it was intended - appears only in the treatment arm (or appears with significantly higher frequency or intensity), it is attributed to the treatment. It should be obvious how the proper use of true placebo control is essential to arriving at the truth in clinical studies of medical treatments. However, one can also see why a dishonest researcher woul...

By David Bell at Brownstone dot org. The Advisory Committee on Immunization Practices (ACIP) of the United States Centers for Disease Control and Prevention (CDC) met recently to discuss, among other topics, the appropriateness of giving Hepatitis B vaccines to all babies in the United States on their first day of life. This practice has been in place for decades, and is in some ways a bit like frontal lobotomies - people just trusted that it was a good idea as otherwise, doctors would not have recommended it. And who wants to argue with health staff on the first day of their baby's life? The committee recommended that parents delay Hepatitis B vaccination for at least 2 months, a decision that provoked a fascinating reaction from many prominent doctors who see this as putting babies at risk, or at least their own bruised egos and reputation. If the average American does pay enough attention to read and think through this issue, they will probably be confused. They would be right to be. We all should be. Much of the hype and argument has been around safety and effectiveness of the vaccine. People will never agree on this, as there is too much at stake for the vaccine industry (lots of money) and too many people annoyed about the money made from vaccines during Covid-19. Resultant extreme and irreconcilable positions range from all vaccines being intrinsically safe and effective in virtually all people (biological magic) to viruses (and Covid) not even existing in the first place. A congenial debate over a beer won't bring reconciliation, as neither side has interest in being congenial. Both claim the other is set on killing humanity. However, these claims are mostly irrelevant to the Hepatitis B vaccines debate. It is really about logic. As the average person, given a couple of minutes, will figure out. Hepatitis B is transmitted by direct contact with the blood or body fluids of other people who have a current Hepatitis B virus infection. It causes liver inflammation and can lead to chronic liver scarring (cirrhosis), liver failure, and liver cancer, all of which can kill you. There are no good treatments to get rid of the virus. It can also remain virtually symptomless and harmless in other people, such that they never know they are infected (but we have good tests). In some countries it is relatively common, such as some Pacific Island nations and some Asian states. However, it is very uncommon in the general population of the United States, being mostly confined to people who inject drugs or have unprotected sex with multiple partners. It is also transmitted within families, at time of birth from the mother, or (for example) if one infected person is bleeding and a family member attends to their wound while having a skin sore of their own. So, if your parents and siblings are Hepatitis B negative (it is easy to do a blood test to check), then in the US you are really, really unlikely to become infected until you start shooting up drugs or having lots of sex, or maybe working as a trauma surgeon or a paramedic. Not many US citizens do any of these things in their first two months, or decade, or so. Pregnant women are also routinely tested for hepatitis B (and fathers can be) so we know, when a baby is born, whether there is any risk from family members. The other relevant thing to understand is that an infant on its first day of life does not have a mature immune system and relies heavily on antibodies obtained from its mother before birth (and some from breast milk). This is partly why we wait a couple of months or more before giving vaccinations against other infections. You would only want to give at birth, amidst all the stresses and rapid changes the baby is undergoing, if immediate risk of an infection was high, such as if the mother had tested positive. So, most Americans will never be exposed to the virus in their lifetimes, which is why the vaccine was originally restricted, rationally, to people at high risk su...

By Clayton J. Baker, MD at Brownstone dot org. As discussed in the introductory essay in this series, standard doctrine surrounding vaccines - pertaining to clinical trials, licensing, marketing, and vaccination schedules - is largely a pseudoscientific façade, constructed on a shaky foundation of falsehoods. In this series, we examine each of the five Big Lies propping up vaccinology, plus two "Honorable Mentions." The Five Big Lies of Vaccinology Big Lie #1: Equating Antibody Production with Immunity to Disease Big Lie #2: Using Fake Placebos Big Lie #3: Insisting My Immunity is Dependent on Your Vaccination Big Lie #4: Declaring Multiple Simultaneous Injections to be Safe Big Lie #5: Declaring Vaccines Fundamentally "Safe and Effective" as a Class Honorable Mention 1: Declaring mRNA Gene Therapies to be Vaccines Honorable Mention 2: Allowing Criminal Corporations to Conduct their own Clinical Studies Big Lie #1: Equating Antibody Production with Immunity to Disease Equating antibody production with immunity to disease is one of the foundational lies of vaccinology. Vaccine manufacturers promote this false equivalence in their clinical trials and in the promotion of their products, both to regulators and to the public. For example, following President Trump's public statement on September 1, 2025 that the manufacturers of the newest Covid-19 injections must reveal their data on the effectiveness of their shots to the public, Pfizer put out a press release on September 8. Pfizer's top-line claim about their latest Covid-19 shot read: Phase 3 clinical trial cohort of adults 65+ and 18-64 with at least one underlying risk condition shows at least a 4-fold increase in LP.8.1-neutralizing antibody titers after receiving the LP.8.1-adapted COVID-19 vaccine 2025-2026 Formula. This might sound impressive. After all, it is Pfizer's self-chosen headliner. It is promoted as confirmation that the shot "works," and placed on the top line of their press release. What it actually says is that the shots caused the recipients to produce about 4 times as much of a particular antibody as before. That's it. It does not, as Pfizer claims, "reinforce pre-clinical data that supported the recent US Food and Drug Administration (FDA) approval of the LP.8.1-adapted Covid-19 vaccine, which demonstrated improved [sic] immune responses against multiple circulating SARS-CoV-2 sublineages." It's just hype. It's like a greedy, overzealous sports agent declaring his 18-year-old pitching prospect to be a perennial Major League All-Star, simply because his young player can chuck the ball at 98 miles per hour. The kid may have a strong arm. But if he can't throw a strike, he's useless. Antibody production, robust or not, is no guarantee of actual, real-world immunity. Not at all. The assertion that if a vaccine invokes a strong antibody response, it will therefore protect you from catching, spreading, or getting sick from an illness is a faulty inference based on false premises. There are two key reasons why equating antibody production to immunity from disease is a lie: Immune system function involves much more than antibody response. The antibody measured in clinical trials may be irrelevant and/or obsolete to the disease in question. Immune System Function Involves Much More Than Antibody Response The first false premise is that antibody production is effectively the sum total of immune system function. The corollary - also false - is that if you can demonstrate antibody production from a vaccine, you have demonstrated it provides immunity from disease. This is a deliberate mischaracterization of the immune system. This false means of measuring so-called "immunogenicity" has been adopted throughout the vaccine industry because it provides a predictable and measurable surrogate for effective immune function. However, this surrogate is both inadequate and misleading. The human immune system is highly complex, beyond the understanding of humanity as a whole...

By Roger Bate at Brownstone dot org. In December 2024, Congress did something unusual: it introduced a bill that openly acknowledges tobacco harm reduction. The POUCH Act of 2024, sponsored by Rep. Jack Bergman (R-MI) and co-sponsored by Rep. Don Davis (D-NC), aims to prevent states and cities from banning or restricting FDA-authorized lower-risk products, including modern nicotine pouches and vaping products. It is a modest bill, but one that finally moves federal policy in a sensible direction. The basic premise is straightforward: if the FDA has determined that a product is appropriate for the protection of public health, states should not be allowed to ban it for political, fiscal, or ideological reasons. This should not be a radical idea, but within the chaos of American nicotine regulation, it almost counts as revolutionary. However, the bill also reveals a deeper truth about why the United States struggles so badly with harm reduction. It exposes the forces that keep smokers tied to cigarettes, protect government revenue streams, and effectively eliminate smaller innovators who cannot survive the regulatory gauntlet. To understand why harm reduction keeps stalling, one must start with a simple reality: state governments make more money from cigarettes than anyone else. The Real Beneficiary of Smoking: State Treasuries Public-health activists often blame "Big Tobacco," but the largest financial beneficiary of smoking in the US is the state itself. For every $100 spent on cigarettes, state coffers typically collect between $60 and $90 through excise taxes, sales taxes, and payments from the Master Settlement Agreement. States have built enormous, stable revenue streams on the backs of smokers. When a smoker switches to nicotine pouches, the state does not merely lose some revenue - it loses most of it immediately. A switch from combustibles to pouches can cut state revenue from around $60-$90 per $100 spent to as little as five or ten dollars. No wonder state governments resist harm reduction. Pouches are good for public health but bad for the budget. This is where Upton Sinclair's observation becomes newly relevant: "It is difficult to get a man to understand something when his salary depends upon his not understanding it." State treasuries do not want to internalize the logic of harm reduction because doing so would mean confronting the fiscal consequences of their dependence on cigarette revenue. Why the POUCH Act Matters - And Why It Falls Short The POUCH Act curbs state-level obstruction by instructing governments to respect the FDA's scientific determinations. If the FDA authorizes a nicotine pouch or vape as appropriate for the protection of public health, it should not be banned by states that prefer the revenue from cigarettes. This restores a basic principle of regulatory coherence. Yet the bill does not address the more fundamental failure at the federal level: the misclassification of nicotine pouches under the Center for Tobacco Products. Nicotine pouches contain no tobacco leaf, produce no smoke, involve no combustion, and have a toxicological profile closer to nicotine replacement therapies. Treating them like cigarettes is scientifically wrong and administratively harmful. The FDA's Pre-Market Tobacco Application process, designed for a different era, demands millions of dollars in data, toxicology, modeling, and population-level analysis. Large cigarette companies can afford these submissions. Smaller and mid-sized innovators cannot. Many have spent years in regulatory limbo, not because their products are unsafe, but because the agency reviewing them is structurally incapable of seeing the bigger picture. Regulators delay, request more studies, and fail to differentiate between high-risk and low-risk products. In this environment, only the largest incumbents can survive long enough to receive FDA authorizations. Small companies fold. Their products vanish not due to safety failures but because the reg...

By Clayton J. Baker, MD at Brownstone dot org. People will believe a big lie sooner than a little one, and if you repeat it frequently enough, people will sooner or later believe it. Walter Langer On November 19, 2025, the New England Journal of Medicine published an article entitled "Efficacy, Immunogenicity, and Safety of Modified mRNA Influenza Vaccine." This article purportedly reviewed the results of Pfizer's Phase 3 clinical trials testing its experimental, mRNA-based, gene therapy injections for Influenza, which Pfizer presents as an alternative to traditional Influenza vaccines. Two weeks later, on December 5, 2025, the Centers for Disease Control's Advisory Committee on Immunization Practices (ACIP) voted 8-3 to end the recommendation in the CDC's pediatric vaccine schedule that all American children receive the Hepatitis B Virus (HBV) vaccine at birth. This recommendation would bring the CDC's HBV vaccine recommendations closer to those in numerous other developed nations, countries that have both better overall pediatric health than the United States and no surplus pediatric HBV deaths. To the casual observer, neither of these events may seem very noteworthy. However, in the post-Covid world of medicine, vaccinology, and politics, both fueled controversy that shows no sign of ending soon. Why? The New England Journal of Medicine article of Pfizer's self-conducted study of its own product has been extensively analyzed by independent reviewers. It has been identified as an object lesson in the scientific fraud that is endemic in vaccine research, development, and marketing. Detailed review of the study has revealed multiple systematic techniques of deceptive research methods, omission and concealment of unfavorable data, and outright misrepresentation of results. The ACIP panel's decision, which represents a minor change in the previously sacrosanct - if ever-expanding - CDC pediatric vaccine schedule, has been met with an onslaught of hair-on-fire, alarmist proclamations by the vaccine industry and its minions of impending disease and death in American children. These claims are unsupported by the existing scientific data and bear little relationship to objective reality as a whole. The reasons these two events have sparked such controversy are: The New England Journal of Medicine article - now thoroughly deconstructed - exposes the brazen, systematic dishonesty of both vaccine development and the clinical trial process as a whole. Meanwhile, the results of the study, once fully uncovered and comprehensively reviewed, shatter the viability of the mRNA gene therapy platform as a substitute for conventional vaccines. The unhinged response to the ACIP decision reveals the entire pediatric vaccine schedule to be a house of cards, built on falsehoods, that cannot withstand any criticism, reform, or revision whatsoever. The awful truth (and it is both awful and the truth) is that vaccinology is overwhelmingly a façade, constructed on a shaky foundation of lies. In the wake of these two recent controversies, it is instructive to enumerate the five great lies propping up vaccinology (plus two Honorable Mentions). I shall outline them here, and provide a more detailed discussion of each in forthcoming essays. The Five Big Lies of Vaccinology Big Lie #1: Equating Antibody Production with Immunity to Disease Big Lie #2: Using Fake Placebos Big Lie #3: Insisting My Immunity is Dependent on Your Vaccination Big Lie #4: Declaring Multiple Simultaneous Injections to be Safe Big Lie #5: Declaring Vaccines Fundamentally "Safe and Effective" as a Class Honorable Mention 1: Declaring mRNA Gene Therapies to be "Vaccines" Honorable Mention 2: Allowing Criminal Corporations to Conduct their own Clinical Studies In upcoming essays, we will analyze each of these Big Lies of Vaccinology. In the process, we shall see how each Big Lie is interdependent upon others, and how the entire vaccine narrative depends upon this web of falsehoods. We...

By Filipe Rafaeli at Brownstone dot org. If you think that in this article I'm going to downplay the deaths, and claim that we should have faced the pandemic without fear or anything like that, you're wrong. That's not what this is about. In terms of importance, the Covid-19 pandemic was the biggest event in human history since World War II. Since that time, nothing has caused as much fear across the entire planet as what began in 2020. Because of the widespread terror, with lockdowns we reached the point of completely stopping the world, something that had never happened before in history. As proof, we were left with the frightening and dystopian photos of huge empty metropolises and airplanes parked on the runways of airports. During the Cold War, with the Cuban Missile Crisis of 1962, when the Soviet Union brought nuclear missiles to Cuba, there was a lot of fear. Some families in the US and Europe even built survival bunkers in their homes. But that didn't even come close to the worldwide scale of the terror caused by Covid-19. However, the fear caused by the Cold War-that feeling that the world could end in nuclear explosions at any moment-even though it was more localized and lasted for a shorter time, quickly gave rise, as a positive side, to a formidable culture: the Beatles, revolutionizing music and interpreting the world, emerged from that. The Rolling Stones and Pink Floyd came from that fear. At the same time, the miniskirt was invented, the contraceptive pill appeared, and sexual freedoms were conquered. In 1968, known as "the year that never ended," young people all over the world wanted to be protagonists and took to the streets of cities on every continent. The hippie movement, of peace and love, arose from that brew. I understand it was a process of liberation, in which the planet's youth buried that well-fed fear of nuclear war. Everyone was thinking and expressing a loud and revolutionary "We want to live." Covid Affected the Elderly Much More For you to keep reading this article, you need to agree with me on one single point. You need to agree that Covid-19 is a disease that affects the elderly much more than young people and children. After all, the elderly have far more comorbidities, accumulated over a lifetime, than the young. This is extremely basic, and I'm not even going to link to scientific studies that prove this fact. Sales Strategy "You vaccinate not only for yourself. You vaccinate also to protect society and particularly to protect those that you love the most," declared Albert Bourla, CEO of Pfizer, at the 2022 World Economic Forum meeting. That was the main message around the entire world. In Brazil, for example, on every television program the message was identical: "The vaccine protects both you and the people around you," stated epidemiologist Pedro Hallal, rector of the Federal University of Pelotas, on TV Globo-Brazil's biggest network-also in early 2022. What few people know is that this message had been previously studied and tested. Before rolling out the vaccines, Yale scientists conducted research to find out which messages would be most effective in getting people to comply. "It is even more effective to add language that frames vaccine uptake as a way to protect others," the scientists concluded in the study. In other words, the entire tone of the vaccination campaign became "Protect grandma." From that point on, with the widely publicized idea that the Covid-19 vaccines were a social pact, politicians in various parts of the world implemented health passes and, in some cases, made vaccination mandatory for everyone-including children and babies. There's Just One Problem with That Message It's not true. The most effective marketing message claimed that Covid-19 vaccines had an ability they never actually had: reducing or stopping transmission. It was October 2022. Rob Roos, a Dutch politician, during a hearing of the European Parliament's Special Committee on Covid-19, asked ...

By Brownstone Institute at Brownstone dot org. President Joe Biden's decision to limit his Supreme Court nominees to black women was widely criticized as a product of DEI-mania, but the ensuing racial controversy was a red herring, a political sleight of hand, designed to distract Americans from Justice Ketanji Brown Jackson's true purpose on the bench: to protect, preserve, and defend the deep state from the constraints of the Constitution. The fallout from the nomination was familiar; CNN's opinion pages called Republican Senators, including Tom Cotton (R-AR), Josh Hawley (R-MO), and Ted Cruz (R-TX), "racist and sexist" for opposing Jackson; Georgetown Law Professor Ilya Shapiro was suspended for stating that the most qualified candidate was an Indian man, not a black woman; Al Sharpton threw his support behind President Biden. But Justice Jackson's position was never intended to be a statement of racial representation or judicial excellence; it was the Biden administration's anointment of a praetorian guard for the unelected and unaccountable bureaucracy that seeks to prevent President Trump from gaining control of the nation. On Monday, the Supreme Court considered whether the President of the United States has the power to remove members of the Executive Branch. The Constitution's Vesting Clause, which states that the "executive Power shall be vested in a President of the United States of America," offers an unequivocal answer. But Jackson, assuming her role as a corporatist advocate on a government salary, acted as the mouthpiece for those opposed to accountability for the bureaucracy that lives off the taxpayers' wages. She warned of "the danger of allowing…the President to actually control the transportation board and potentially the Federal Reserve and all these other independent agencies." Jackson, never known for speaking concisely or deliberately (in oral arguments, she speaks 50 percent more than any of her fellow colleagues and more than Justices Amy Coney Barrett, John Roberts, and Clarence Thomas combined) waxed longingly for a nation with no presidential control over the executive branch: My understanding was that independent agencies exist because Congress has decided that some issues, some matters, some areas should be handled in this way by nonpartisan experts, that Congress is saying that expertise matters with respect to aspects of the economy and transportation and the various independent agencies that we have. So having a President come in and fire all the scientists and the doctors and the economists and the Ph.D.s and replacing them with loyalists and people who don't know anything is actually not in the best interest of the citizens of the United States. This is what I think Congress's policy decision is when it says that these certain agencies we're not going to make directly accountable to the President. This is not a mere coincidence; when nominated, the Biden administration knew that she was devoted to bureaucratic supremacy. In the first Trump administration, Jackson, then a District Court Judge, overturned four executive orders (numbers 13837, 13836, 13839, and 13957) that sought to rein in the power of the nearly three million federal employees who effectively inhabit permanent jobs. Most notably, in 2020, she invalidated President Trump's order "Creating Schedule F in the Excepted Service." In March 2024, the Supreme Court heard oral arguments in Murthy v. Missouri, which considered the Biden administration's collusion with Big Tech to censor Americans during the Covid response. There, Justice Jackson stated that her "biggest concern" was that an injunction would result in "the First Amendment hamstringing the Government." Earlier this year, Justice Barrett chastised Justice Jackson as "embracing an imperial Judiciary" after Justice Jackson voted to increase federal courts' power to issue nationwide injunctions. Jackson's defense of the unelected cabal that dominates American life is not a...