Article Text

other Versions

Download PDFPDF
A randomised controlled trial of ribavirin in Crimean Congo haemorrhagic fever: ethical considerations
  1. B Arda1,
  2. A Aciduman1,
  3. J C Johnston2,3
  1. 1Department of Medical Ethics and History of Medicine, Faculty of Medicine, Ankara University, Ankara, Turkey
  2. 2Private practice, Seattle, Washington, USA
  3. 3Department of Neurology, Addis Ababa University, Ethiopia
  1. Correspondence to Professor Berna Arda, Department of Medical Ethics, Faculty of Medicine, Ankara University, Ankara, Turkey; arda{at}


The randomised controlled trial (RCT) constitutes a quantitative, comparative, controlled study of a particular treatment, and provides invaluable evidence regarding its pharmacotherapeutic efficacy. These studies are generally predicated upon the ethical principle of clinical equipoise. However, this may be insufficient to justify withholding treatment from a control group while assessing drug therapy in a potentially fatal disease. Thus, the criteria for randomisation, informed consent methodology and timing, and consideration of treatment options in such a scenario remain the province of medical ethics. This paper addresses the need for an RCT of ribavirin in the treatment of Crimean Congo haemorrhagic fever, and highlights underlying ethical concerns in light of the current medical, virological and ethical literature.

  • Crimean Congo haemorrhagic fever
  • randomised controlled trial
  • ethics
  • ribavirin
  • placebo
  • informed consent
  • publishing ethics
  • human rights in medicine
  • gen-ethics
  • ethics education
  • legal aspects
  • negligence
  • neuroethics

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.