Excellence, however, does not mean perfection. Throughout the book there are assumptions that need to be challenged. For instance, chapter 8 explicitly, and several others chapters implicitly, starts with the view that good science is good ethics. Although the reverse, that bad science is bad ethics, is certainly true, defining the "good" in good science requires further scholarly and public debate. One of the basic tenets of "good" science is efficiency. But the ethical implications of efficiencies weighed against the potentials for pain and suffering of individual subjects and their families are not easily elucidated, and they are not explored in this book. Nor does the book address the fundamental ethical questions of "Is psychic pain similar to, the same as, or different from physical pain?" and "If psychic pain is different from physical pain, what might be the specific ethical implications for protocol performance and subject monitoring?"