Journal of Medical Ethics 45 (10):662-667 (2019)

Ariella Binik
McMaster University
Ethics has been identified as a central reason for choosing the stepped wedge trial over other kinds of trial designs. The potential advantage of the stepped wedge design is that it provides all arms of the trial with the active intervention over the course of the study. Some groups receive it later than others, but the study intervention is not withheld from any group. This feature of the stepped wedge design seems particularly ethically advantageous in two instances: when the study intervention appears especially likely to be effective and when the consequences of not receiving the intervention may be dire. But despite an increase in the use of the stepped wedge design and appeals to its ethical superiority as the motivation for its selection, there has been limited attention to the stepped wedge trial in the ethics literature. In the following, I examine whether there are persuasive ethical reasons to prefer or to require a stepped wedge trial. I argue that while the stepped wedge design is ethically permissible, it is not morally superior to other kinds of trials. To this end, I examine the ethical justification for providing, withholding, and delaying interventions in research.
Keywords No keywords specified (fix it)
Categories (categorize this paper)
DOI 10.1136/medethics-2018-105138
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: 63,295
Through your library

References found in this work BETA

Selecting the Right Tool For the Job.Arthur L. Caplan, Carolyn Plunkett & Bruce Levin - 2015 - American Journal of Bioethics 15 (4):4-10.

View all 12 references / Add more references

Citations of this work BETA

Add more citations

Similar books and articles


Added to PP index

Total views
8 ( #977,506 of 2,448,749 )

Recent downloads (6 months)
1 ( #447,034 of 2,448,749 )

How can I increase my downloads?


My notes