RT Journal Article
SR Electronic
T1 Randomisation and resource allocation: a missed opportunity for evaluating health care and social interventions
JF Journal of Medical Ethics
JO J Med Ethics
FD BMJ Publishing Group Ltd and Institute of Medical Ethics
SP 319
OP 322
DO 10.1136/jme.26.5.319
VO 26
IS 5
A1 Tami Toroyan
A1 Ian Roberts
A1 Ann Oakley
YR 2000
UL http://jme.bmj.com/content/26/5/319.abstract
AB Equipoise is widely regarded to be an essential prerequisite for the ethical conduct of a randomised controlled trial. There are some circumstances however, under which it is acceptable to conduct a randomised controlled trial (RCT) in the absence of equipoise. Limited access to the preferred intervention is one such circumstance. In this paper we present an example of a randomised trial in which access to the preferred intervention, preschool education, was severely limited by resource constraints. The ethical issues that arise when conducting randomised trials in health care are considered in the context of trials of social interventions. In health, education and social welfare, effective interventions are frequently limited due to budgetary constraints. Explicit acknowledgement of the need to ration interventions, and the use of random allocation to do this even in the absence of equipoise, would facilitate learning more about the effects of these interventions.