David Bourget (Western Ontario)
David Chalmers (ANU, NYU)
Rafael De Clercq
Jack Alan Reynolds
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Theoretical Medicine and Bioethics 31 (2):107-122 (2010)
Robert Truog describes the controversial randomized controlled trials (RCTs) of extracorporeal membrane oxygenation (ECMO) therapy in newborns. Because early results with ECMO indicated that it might be a great advance, saving many lives, Truog argues that ECMO should not have been tested using RCTs, but that a long-term, large-scale observational study of actual clinical practice should have been conducted instead. Central to Truog’s argument, however, is the idea that ECMO is an unusual case. Thus, it is an open question whether Truog’s conclusions can be extended to other areas of medical research. In this paper, I look at epistemological and ethical issues arising in the care of patients with chronic diseases, using ECMO as a starting point. Both the similarities and the dissimilarities of these two cases highlight important issues in biomedical research and support a conclusion similar to Truog’s. Observational studies of clinical practice provide the best evidence to inform the treatment of patients with chronic disease.
|Keywords||Randomized controlled trials Research ethics ECMO Chronic disease Research methods|
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References found in this work BETA
Robyn Bluhm (2009). Some Observations on “Observational” Research. Perspectives in Biology and Medicine 52 (2):252-263.
Kirstin Borgerson (2009). Valuing Evidence: Bias and the Evidence Hierarchy of Evidence-Based Medicine. Perspectives in Biology and Medicine 52 (2):218-233.
Nancy Cartwright (2007). Are Rcts the Gold Standard? Biosocieties 1:11-20.
J. Grossman & F. Mackenzie (2005). The Randomized Controlled Trial: Gold Standard or Merely Standard? Perspectives in Biology and Medicine 48 (4):516-34.
Peter Urbach (1985). Randomization and the Design of Experiments. Philosophy of Science 52 (2):256-273.
Citations of this work BETA
L. McClimans (2013). The Role of Measurement in Establishing Evidence. Journal of Medicine and Philosophy 38 (5):520-538.
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