July 20, 1967

Dr. Maurice B. Visacher

Department of Physiology

University of Minnesota Medical School
Minneapolis, Minnesota 55455

Dear Mr. Visscher:
This is in reply to your of July 14.

To answer your request, I am enclosing a copy of the talk I gave at the ACP
meeting. This will be published in a September supplement to the Annals

of Internal Medicine. However, I think the main point you might be interested
in was included in the informa] discussion, and although I don't have a good
copy of this at hand, I have incorporated the gist of it in the Washington
Post columns also enclosed.

Do you have in your files a copy of a report this last year by a California
State Senate committee dealing with the release of animals from pounds? This
did strike me ag an unusually thohghtful study, and if you don't already have
& copy I will try to dig out either a copy or a reference to it.

I fully agree with every point that you made inthe last pearggreph of your
letter to Seience. I am afraid many of the abuses of bureaucratic fastidious-
ness are inevitable, once the profession abdicated its responsibility for the
thoughtful use of new agents. I would, however, ‘be alarmed at a possible
implication of the third point of your first paragraph, namely that one might
discover the clinical non-utility of a new drug by a pilot study which had not
been preceded by sufficient precautions concerning possible toxicity. So
everything hinges on "excessively elaborate”, doesn't it?

I would be inclined to put the shoe on the other foot at a somewhat later atage
in the process. We could afford to take somewhat larger risks with important
new therapeutics provided we could be sure that their early use was confined
to practitioneers who really knew what they were doing, and would be on careful
watch for reversible side effects. I will impose on you by enclosing some
additional writings on this theme.

Yours sincerely,

Joshus Lederberg
Professor of Genetics

MIHDSSI/