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Cassander, completely agree with you about being addictive and clouding judgement but I don't think risk taking is a bad thing as long as one acts ethically. I also feel that it means neither being pessimistic or optimistic (think over taking on a bend) but having a good grasp of reality. With more and complete information a range of choices can be made that actually reduces risk. Of course, with complexity and wicked issues come uncertainty and with that comes the risks. I agree the good of the patient should come before ego. I tend to agree with most of what harford is arguing - except perhaps control groups but then again I'm not a natural scientist.