By Alan Cassels at Brownstone dot org.

[Book review of How Merck and Drug Regulators Hid Serious Harms of the HPV Vaccine by Dr. Peter Gøtzsche (Skyhorse, 2025)]

Over 30 years of studying and writing about drug policy, and documenting the fascinating machinations of regulators, drug companies, medical experts, and corporate spokespeople, I have often found myself staring into the dark hole of epistemology, the branch of philosophy concerned with the nature, sources, and limits of knowledge. Basically, when we say we "know" something, what does that even mean?

If one were to ask me, "How trustworthy or complete is our knowledge base underpinning the effects of prescription drugs or vaccines?" you might find my answer impertinent:

"If you want the real truth about drugs, don't ask doctors - ask lawyers."

Which is to say, the medical world is only able to deliver us so much truth; to go deeper where true knowledge lies, you have to employ law and philosophy, in an arena where you can ask real questions and question answers.

The world of clinical trials and medical regulators can put on a good show, even though many of us can see through the performative regulation and performative ghost-managed "science" designed to reassure investors and bamboozle doctors while utterly failing to provide information that's meaningful to patients. Rarely does the medical system slip off its armour of hubris to seek out true epistemological gold. If you think you already have the real truth, why would you search for any further?

In many examples over the last few decades, I have noticed that the rigour of the courtroom remains one of the best tools we have to scrutinize the validity and reliability of clinical evidence, understand its limits, and challenge the authority of experts and regulators. Establishing knowledge about drug effects is not a popularity contest.

Most of us would agree that information on the likelihood of expected drug effects should be assessed by the cleanest, most unbiased, and rigorous studies humans can devise.

Epistemology reminds us that scientific knowledge is provisional and fallible. In the context of drugs, it means acknowledging that what we believe to be true - such as a drug's level of safety or efficacy - may change with new evidence or reinterpretation of existing data. This humility is vital to prevent dogmatic adherence to outdated or incomplete information. Sadly, it often takes a courtroom, high stakes, and tons of money to get under the layers of performative 'science.'

Those thoughts came to mind after reading a new book by the Danish physician and researcher, Dr. Peter Gøtzsche, a giant among skeptics whom I've nicknamed the Dauntless Dane. He's a fearless, relentless truth-seeker whose penetrating blue eyes seem to look straight into your soul when he speaks.

He's frequently accused of being arrogant and unrelenting, but one thing is clear: He's never one to back down from a fight, and he's usually on the right side. Not one to shy away from difficult truths and bow to industry (and legal) pressure, his intellectual heft has been aimed at tackling important public health questions, such as the value of mammography, or evaluating the harms of psychiatric drugs.

Over a decade ago, I became aware of his work in mammography and interviewed him for my book, Seeking Sickness: Medical Screening and the Misguided Hunt for Disease. I interacted with him frequently when researching and writing a book on the Cochrane Collaboration, an organization he was fundamental in creating, and by whose hand he was tarnished and thrown to the dogs. (that saga is thoroughly covered in several of his recent books).

I have seen the Dauntless Dane many times take a battering in the ring and can attest that beneath his formidable exterior is a mind of relentless clarity and dedication to truth.

His newest book, How Merck and Drug Regulators Hid Serious Harms of the HPV Vaccines (Skyhorse, 2025), stands as a fierce indictment of...