ABSTRACT
The benefi ts and harms of pharmaceuticals are principal subjects of investigation in clinical science. In this chapter I discuss how harms are measured and note the challenges that clinical research faces in detecting harms of pharmaceuticals. This chapter provides an introduction to the structure of clinical research with a focus on harm detection. As it is usually performed today, clinical research does not reliably measure the harms of pharmaceuticals. There are at least three categories of problems with clinical research that lead to the underestimation of the harm profi le of pharmaceuticals: subtle features of research methodology, secrecy surrounding the evidence from clinical research, and inadequate regulation.
