RT Journal Article
SR Electronic
T1 Can unequal be more fair? Ethics, subject allocation, and randomised clinical trials.
JF Journal of Medical Ethics
JO J Med Ethics
FD BMJ Publishing Group Ltd and Institute of Medical Ethics
SP 401
OP 408
DO 10.1136/jme.24.6.401
VO 24
IS 6
A1 Avins, A L
YR 1998
UL http://jme.bmj.com/content/24/6/401.abstract
AB Randomised clinical trials provide the most valid means of establishing the efficacy of clinical therapeutics. Ethical standards dictate that patients and clinicians should not consent to randomisation unless there is uncertainty about whether any of the treatment options is superior to the others ("equipoise"). However, true equipoise is rarely present; most randomised trials, therefore, present challenging ethical dilemmas. Minimising the tension between science and ethics is an obligation of investigators and clinicians. This article briefly reviews several techniques for addressing this issue and suggests that unbalanced randomisation, a technique rarely employed in current clinical trial practice, may be useful for enhancing the ethical design of human experimentation.