One might argue that we have calibrated drug safety to such a high degree that the aggregate negative social impacts are far higher than the costs of side effects. Of course we don’t want another thalidomide catastrophe but I think there are large potential test groups to mine who are much less sensitive to the risks. For example, the elderly and those with terminal diagnoses. Right now we only permit drug testing in very limited cases for the latter group, and only when the treatment is related to their terminal diagnosis. I’m seeing older people taking all kinds of experimental anti-aging drugs right now, either off label, or novel. We’re not collecting any of this data empirically because what they’re doing is not legal.

Further, [we are getting much better at simulating drug interactions.](https://pubmed.ncbi.nlm.nih.gov/41155903/) I strongly suspect AI will offer new probabilistic models to funnel novel drugs into more targeted trials which are much more likely to succeed. If we had 90% certainty of success and high certainty of lower adverse reactions I think we could allow much less stringent human trials. That means much lower cost and much faster turn-around.