That's an unrealistically idealized view of drug development. The human use of drugs long predates anything resembling a modern concept of a biochemical mechanism. Nobody knew how morphine relieved pain, but they knew that it worked and they used it.

Today we'll generally have a proposed mechanism, but it's not necessarily correct. Acetaminophen is among the oldest and most commonly used synthetic drugs, and its mechanism is still debated. This isn't usually cause for any special concern, since our confidence in the drug's efficacy and safety comes more from animal or human trials than from mechanistic understanding. Serendipitous discoveries during human trials are still common; the first inkling that Viagra might treat ED came not from any "first seminal paper" but from the volunteers who were testing it for angina.

Clinical trials are regulatory matters. Your suggestion that it could be "unclear who conducted the phase 3" is very strange--the FDA knows who filed the application. Of course that filer could have committed fraud, but I see nothing in the slides to suggest that was the concern here. If it was, then the solution would be a non-fraudulent phase 3, not anything related to mechanistic insight.

This is a strawman. No one’s saying it’s going to be sudden or anything. It’s gonna have clear provenance and the same type of verification channels

I’m not sure who u or Tao is arguing against.

EDIT: people have a hard time choosing between

1. Yeah it’s pure slop and completely useless

2. Oh no OpenAI has stolen my ideas and solved all my problems and we have nothing to do

My dude, if OpenAI’s dump were really that worthless to be as good as noise, why is Tao getting agitated? Just like ignore it or something.