David Bourget (Western Ontario)
David Chalmers (ANU, NYU)
Rafael De Clercq
Ezio Di Nucci
Jack Alan Reynolds
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Kennedy Institute of Ethics Journal 13 (2):93-118 (2003)
: When may a physician legitimately offer enrollment in a randomized clinical trial (RCT) to her patient? Two answers to this question have had a profound impact on the research ethics literature. Equipoise, as originated by Charles Fried, which we term Fried's equipoise (FE), stipulates that a physician may offer trial enrollment to her patient only when the physician is genuinely uncertain as to the preferred treatment. Clinical equipoise (CE), originated by Benjamin Freedman, requires that there exist a state of honest, professional disagreement in the community of expert practitioners as to the preferred treatment. FE and CE are widely understood as competing concepts. We argue that FE and CE offer separable and, in themselves, incomplete justifications for the conduct of clinical trials. FE articulates conditions under which the fiduciary duties of physician to patient may be upheld in the conduct of research. CE sets out a standard for the social approval of research by institutional review boards. Viewed in this way, FE and CE are not necessarily competing notions, but rather address complementary moral concerns
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Citations of this work BETA
Paul B. Miller & Charles Weijer (2006). Fiduciary Obligation in Clinical Research. Journal of Law, Medicine & Ethics 34 (2):424-440.
T. Phillips (2011). From the Ideal Market to the Ideal Clinic: Constructing a Normative Standard of Fairness for Human Subjects Research. Journal of Medicine and Philosophy 36 (1):79-106.
Alex John London (2006). The Moral Foundations of Equipoise and its Role in International Research. American Journal of Bioethics 6 (4):48 – 51.
Sven Ove Hansson (2006). Uncertainty and the Ethics of Clinical Trials. Theoretical Medicine and Bioethics 27 (2):149-167.
Mark Sheehan, Claire Timlin, Ken Peach, Ariella Binik & Wilson Puthenparampil (2014). Position Statement on Ethics, Equipoise and Research on Charged Particle Radiation Therapy. Journal of Medical Ethics 40 (8):572-575.
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