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The evidence is not strong enough to recommend for or against use of supplements of vitamins A, C, or E, multivitamins with folic acid, or antioxidant combinations for prevention of cancer and cardiovascular disease (CVD), according to the latest deliberations of the United States Preventive Services Task Force (Guidelines, p. 51). The USPSTF recommends against use of beta-carotene supplements (either alone or in combination) for prevention of cancer or CVD because good quality evidence shows that beta-carotene supplements provide no benefit in prevention cancer or CVD in middle aged and older adults. Beta-carotene supplements may be harmful, according to two trials in which heavy smokers who took beta-carotene supplements had a higher incidence of lung cancer and death from all causes.
More and more people are filing lawsuits against investigators, institutional review boards (IRBs) and academic institutions in research involving human subjects. The grounds for legal action vary widely, and class action suits are increasingly common. The threat of legal action could result in more careful research and better protection for human subjects (Academia nd Clinic, p. 40). Lawsuits will also increase costs (for damages to injured subjects and legal defense), weaken an IRB's ability to attract thoughtful committee members, and make the IRBs more conservative, legalistic and regulatory, the authors say.
(This article was first published online at www.annals.org on May 6, 2003.)