EDITORIAL
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Don’t judge, treat Vague moral misgivings must not obstruct therapy for steroid rage IMAGINE a drug that could surgery or been injured playing dampen aggression in people a dangerous sport on the grounds prone to acts of random, that they shouldn’t have done it in unprovoked violence. Would you the first place. Similarly, we treat deny that drug to somebody who people who have smoked, drunk really wanted it? Probably not. or drugged themselves to death’s But what if that person was door. Steroid abusers should suffering from “roid rage”, a expect the same level of care. proven side effect of anabolic “We don’t deny medical steroid abuse? Chances are you care to people who would think twice. Why should have suffered botched somebody who has chosen to cosmetic surgery” take a risky recreational drug be entitled to medical treatment that allows them to carry on? That is That they will get it is doubtful. exactly the dilemma that doctors There is something morally may soon face. As we report on offensive about offering a medical page 12, the causes of roid rage intervention that would give are becoming clearer and it seems steroid abusers an excuse not to plausible that existing drugs address the root of the problem – could be used to combat it. namely the steroids. There is a So should we treat roid rage? precedent here. A drug called Of course we should. We don’t propylthiouracil, currently used deny medical care to people who to treat an overactive thyroid, have suffered botched cosmetic may protect heavy drinkers
from cirrhosis. But fears that it would give alcoholics free rein to carry on drinking appear to have prevented the testing of the drug for this purpose. A more rational worry is that a roid-rage blocker might encourage people who would otherwise have abstained to abuse steroids. This seems unlikely. Steroids are overwhelmingly abused by young men for whom another of the potential side effects – sexual dysfunction – is surely more unappealing than rage, yet that doesn’t seem to put them off. We need to be pragmatic. The scale of steroid abuse, particularly among young male athletes, is staggering. We are all potential victims of roid rage. Those who object to blockers on moral grounds should consider the moral implications of their actions. n
The bonus paradox COMPANIES pay bonuses for all sorts of reasons. One is to link salaries to profits to help keep wage bills down in bad years. Another, of course, is to make people work harder. It is for this last reason that governments in several countries have introduced performance-related pay for many of their employees over the past 30 years.
Yet as our feature on page 40 shows, paying for results doesn’t always boost performance. In fact it can make it worse. The problem runs far deeper than the practical difficulties of measuring performance and the ill will that such schemes can create. Contrary to what economists believe, offering rewards, particularly in jobs
that people do for love as well as money, can actually undermine the motivation of workers. In one of the largest trials of performance-related pay so far, in the healthcare sector in the UK, the generous rewards on offer made no discernible difference. Such findings should make governments and institutions demand hard evidence that bonus schemes really are delivering, and that they are not just throwing money away. n
Life beyond the Goldilocks zone
galaxy could heat an alien world enough to make it habitable, even without the warm glow of starlight (see page 16). Astronomers are far from impressed, since these darkmatter worlds will be hard to detect. But surely that is not the point. These free-floating worlds – if they exist – would be the only
warm spots left trillions of years from now (New Scientist, 2 April, p 37). If nothing else, this work illustrates how we have yet to think through the possibilities for extending a star’s Goldilocks zone, where Earth-like planets are awash with liquid water. Even when all the starlight has faded, life may find a way. n
GOOD news for all those who fret about the fate of life in the cosmos. Dan Hooper and Jason Steffen of Fermilab in Batavia, Illinois, calculate that the dark matter that lies at the heart of the
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