Theoretical Medicine and Bioethics 30 (4):269-288 (2009)

Since its introduction in 1987, Benjamin Freedman’s principle of clinical equipoise has enjoyed widespread uptake in bioethics discourse. Recent years, however, have witnessed a growing consensus that the principle is fundamentally flawed. One of the most vocal critics has undoubtedly been Franklin Miller. In a 2008 paper, Steven Joffe and Miller build on this critical work, offering a new conception of clinical research ethics based on science, taking what they call a “scientific orientation” toward the ethics of clinical research. Though there is much to recommend Joffe and Miller’s scientifically oriented conception of clinical research ethics, I believe that both the critical and constructive projects suffer from the same basic mistake: inattention to context. The internal norms of science cannot be fully specified, let alone satisfied, independently of contextual (external) factors that only come into view when we are attentive to the particular context of that form of inquiry.
Keywords Equipoise  Medicine  Research  Practice  Epistemology  Ethics
Categories (categorize this paper)
DOI 10.1007/s11017-009-9104-6
Edit this record
Mark as duplicate
Export citation
Find it on Scholar
Request removal from index
Revision history

Download options

PhilArchive copy

Upload a copy of this paper     Check publisher's policy     Papers currently archived: 62,448
External links

Setup an account with your affiliations in order to access resources via your University's proxy server
Configure custom proxy (use this if your affiliation does not provide a proxy)
Through your library

References found in this work BETA

Speech Acts: An Essay in the Philosophy of Language.William P. Alston - 1970 - Philosophical Quarterly 20 (79):172-179.

View all 20 references / Add more references

Citations of this work BETA

Who's in Control of the Choice of Control?James A. Anderson - 2009 - American Journal of Bioethics 9 (9):60-62.

Add more citations

Similar books and articles

Equipoise and the Ethics of Clinical Research Revisited.Franklin G. Miller - 2006 - American Journal of Bioethics 6 (4):59-61.
The Real Problem with Equipoise.Winston Chiong - 2006 - American Journal of Bioethics 6 (4):37 – 47.
Clinical Equipoise and the Incoherence of Research Ethics.Franklin G. Miller & Howard Brody - 2007 - Journal of Medicine and Philosophy 32 (2):151 – 165.
What Makes Placebo-Controlled Trials Unethical?Franklin G. Miller & Howard Brody - 2002 - American Journal of Bioethics 2 (2):3 – 9.
Pulling the Plug on Clinical Equipoise: A Critique of Miller and Weijer.Fred Gifford - 2007 - Kennedy Institute of Ethics Journal 17 (3):203-226.
Articulating and Responding to Uncertainties in Clinical Research.Benjamin Djulbegovic - 2007 - Journal of Medicine and Philosophy 32 (2):79 – 98.


Added to PP index

Total views
80 ( #133,114 of 2,446,175 )

Recent downloads (6 months)
1 ( #456,899 of 2,446,175 )

How can I increase my downloads?


My notes