American Journal of Bioethics 9 (9):34-48 (2009)

Authors
Jeremy Howick
Oxford University
Abstract
A resilient issue in research ethics is whether and when a placebo-controlled trial is justified if it deprives research subjects of a recognized treatment. The clinicians' moral duty to provide the best available care seems to require the use of ‘active’ controlled trials that use an established treatment as a control whenever such a therapy is available. In another regard, ACTs are supposedly methodologically inferior to PCTs. Hence, the moral duty of the clinical researcher to use the best methods will favor PCTs. In this target article, I analyze the three reasons for believing that ACTs are inferior to PCTs namely: 1) ACTs lack ‘assay sensitivity’; 2) ACTs do not measure absolute effect size; and 3) ACTs require more participants; and I contend that none are acceptable. Consequently the tension between clinical and research ethics dissolves: the moral duty of the clinician to avoid PCTs is unopposed by methodological considerations.
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DOI 10.1080/15265160903090041
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References found in this work BETA

Evidence in Medicine and Evidence-Based Medicine.John Worrall - 2007 - Philosophy Compass 2 (6):981–1022.
What Makes Placebo-Controlled Trials Unethical?Franklin G. Miller & Howard Brody - 2002 - American Journal of Bioethics 2 (2):3 – 9.
The Placebo Concept in Medicine and Psychiatry.A. Grunbaum - 1986 - Psychological Medicine 16 (1):19-38.

View all 8 references / Add more references

Citations of this work BETA

Knowledge and Belief in Placebo Effect.Daniele Chiffi & Renzo Zanotti - 2017 - Journal of Medicine and Philosophy 42 (1):70-85.

View all 35 citations / Add more citations

Similar books and articles

What Makes Placebo-Controlled Trials Unethical?Franklin G. Miller & Howard Brody - 2002 - American Journal of Bioethics 2 (2):3 – 9.
The Philosophy of Evidence-Based Medicine.Jeremy Howick - 2011 - Wiley-Blackwell, Bmj Books.
Is All Therapy Just a Placebo Effect?Olov Lindahl & Lars Lindwall - 1982 - Theoretical Medicine and Bioethics 3 (2):255-259.
The Necessity and the Value of Placebo.Ernst A. Singer - 2004 - Science and Engineering Ethics 10 (1):51-56.

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