The book concludes by articulating what medical nihilism might entail for medical research, regulation, and treatment. There have been many proposed solutions to problems raised in this book, ranging from minor modifications to medical research (like requiring the registration of trials prior to data collection, and open access to trial data), to revolutionary changes (such as the complete socialization of medical research). These proposals for realigning medical research are evaluated, and proposals that are consistent with medical nihilism are articulated. These include stricter standards for detecting benefits and harms of medical interventions, a closer scrutiny of corporate research, and a shift in the research agenda away from barely effective pharmaceuticals toward projects with potential for greater impact, such as research on the importance of diet and exercise, and on neglected tropical diseases.
