The conflict between randomized clinical trials and the therapeutic obligation
Journal of Medicine and Philosophy 11 (4):347-366 (1986)
| Abstract | The central dilemma concerning randomized clinical trials (RCTs) arises out of some simple facts about causal methodology (RCTs are the best way to generate the reliable causal knowledge necessary for optimally-informed action) and a prima facie plausible principle concerning how physicians should treat their patients (always do what it is most reasonable to believe will be best for the patient). A number of arguments related to this in the literature are considered. Attempts to avoid the dilemma fail. Appeals to informed consent and mechanisms for minimizing the resulting harm are important for policy, but informed consent is problematic and mechanisms for minimization of harm do not address the dilemma. Appeals to some sort of contract model of justification are promising and illuminating. Keywords: randomized clinical trials, ethics CiteULike Connotea Del.icio.us What's this? | |||||||||
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Howard Mann (2002). Therapeutic Beneficence and Patient Recruitment in Randomized Controlled Clinical Trials. American Journal of Bioethics 2 (2):35 – 36.
Don Marquis (1986). An Argument That All Prerandomized Clinical Trials Are Unethical. Journal of Medicine and Philosophy 11 (4):367-383.
N. Waller Bruce (1995). Individual Autonomy and the Double-Blind Controlled Experiment: The Case of Desperate Volunteers. Journal of Medicine and Philosophy 20 (1).
Lisa R. Stines & Norah C. Feeny (2008). Unique Ethical Concerns in Clinical Trials Comparing Psychosocial and Psychopharmalogical Interventions. Ethics and Behavior 18 (2 & 3):234 – 246.
James E. Sabin Kathleen Mazor Vanessa Meterko Sarah L. Goff Richard Platt (2008). Comparing Drug Effectiveness at Health Plans: The Ethics of Cluster Randomized Trials. Hastings Center Report 38 (5):pp. 39-48.
Dennis Drotar, Victoria Miller, Victoria Willard, Kyle Anthony & Eric Kodish (2004). Correlates of Parental Participation During Informed Consent for Randomized Clinical Trials in the Treatment of Childhood Leukemia. Ethics and Behavior 14 (1):1 – 15.
David Wendler (2009). Must Research Participants Understand Randomization? American Journal of Bioethics 9 (2):3 – 8.
Franklin G. Miller & Howard Brody (2007). Clinical Equipoise and the Incoherence of Research Ethics. Journal of Medicine and Philosophy 32 (2):151 – 165.
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Loretta Kopelman (1986). Consent and Randomized Clinical Trials: Are There Moral or Design Problems? Journal of Medicine and Philosophy 11 (4):317-345.
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