Equipoise, consent and the ethics of randomised clinical trials
نویسنده
چکیده
A doctor has a duty to give his patient what he believes to be the best treatment. An ethical prerequisite of recommending her to enter a randomised clinical trial (RCT), in which his patient will be randomly allotted to one of two or more treatments, is, as Michael Baum in his chapter stresses, that he is ignorant about their relative efficacy and, hence, justifiably indifferent as to which she receives. Writers who deny that a doctor's duty to his individual patient can be overriden by the need to advance science and so benefit future patients, commonly attack RCTs by asserting that rarely, even at the outset of an RCT, can a doctor be indifferent to the treatments being tested. Consequently recommending his patient to enter an RCT will almost invariably contravene his duty to give her the treatment he believes to be the best.
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