Jeremy Howick
Oxford University
The feature of being ‘double blind’, where neither patients nor physicians are aware of who receives the experimental treatment, is universally trumpeted as being a virtue of clinical trials. The rationale for this view is unobjectionable: double blinding rules out the potential confounding influences of patient and physician beliefs. Nonetheless, viewing successfully double blind trials as necessarily superior leads to the paradox that very effective experimental treatments will not be supportable by best (double-blind) evidence. It seems strange that an account of evidence should make a priori judgments that certain claims can never be supported by ‘best evidence’. So far as treatments with large effects go, the claim that they are effective is highly testable and intuitively they should receive greater support from the evidence. In this paper I argue that the two potential confounders ruled out by double blinding are often not actual confounders outside placebo controlled trials of treatments with mild effects and that have subjective outcome measures.
Keywords clinical trial  blinding  placebo  double-blind  randomised trial
Categories (categorize this paper)
Reprint years 2008
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: 71,436
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

No references found.

Add more references

Citations of this work BETA

Just a Paradigm: Evidence-Based Medicine in Epistemological Context.Miriam Solomon - 2011 - European Journal for Philosophy of Science 1 (3):451-466.

Add more citations

Similar books and articles


Added to PP index

Total views
67 ( #173,043 of 2,520,359 )

Recent downloads (6 months)
1 ( #406,012 of 2,520,359 )

How can I increase my downloads?


My notes