I understand what you’re saying, and honestly, I’ve always...

I understand what you’re saying, and honestly, I’ve always struggled with ethics myself. It’s a noble idea in theory, but in practice, it often feels like it's trying to function in a contradictory environment.

Take two examples. First, the belief that we should help all sick people and provide medical care regardless of cost—ethically, that sounds right. But without incentives, no one is going to invest the time, money, or risk to develop those treatments in the first place. So in that sense, the system becomes ethically flawed by its own logic.

Second, look at Phase 1 clinical trials. The initial dosage given to the first participant is usually so low that it’s unlikely to provide any benefit. Ethically, you’re supposed to disclose everything so participants can make a fully informed decision. But in practice, if people truly understood that the first dose probably won't help them at all, few would want to go first—maybe you'd get someone tenth in line, at best, for argument’s sake.

That’s the paradox I keep coming back to. Ethics demands transparency and fairness, but that same transparency can obstruct progress. So while ethics is a great concept, I do sometimes wonder if it's actually practical in the real world.

Don’t feel you need to respond—I realise this could place you in a difficult position. But these are the kinds of contradictions that keep me questioning how we apply ethics, and whether we’re really serving patients, science, or just the process.