sck@elsie.UUCP (Steve Kaufman) (05/24/85)
In article <10970@brl-tgr.ARPA>, wmartin@brl-tgr.ARPA (Will Martin ) writes: > > A general query about controlled experiments... > > If you are testing a truly effective medication, say for some serious > disease or condition, ... > where some participants get placebos and some the medication, and a > number of the control group die because they got only placebos, while > all the test subjects survive because this experimental medication was > really effective, have you not violated the Hippocratic oath ... > .... by denying this (admittedly experimental) medication to people > who could possibly have been saved by it? > I think the following quotes from a recent book on clinical trials provide a good response to this question: "Presumably, the reason that a clinical trial is being considered at all is that there is uncertainty about the potential benefits of a new intervention. If an investigator believes --for whatever reason-- that the new intervention is more beneficial or harmful than the old, he should not participate in the trial. If, on the other hand, he has sufficient doubt about which intervention is better, then he is ethically justified in participating in a randomized clinical trial to settle the question. ... under these circumstances, randomization is a more ethical way of practicing medicine than the routine prescribing of medication or therapy that has never been proven to be beneficial ... and could possibly be harmful." (pp. 31-2) "Of course, some results, such as the effectiveness of penicillin in pneumococcal pneumonia, are so highly dramatic than no comparison group is needed. Successful results of this magnitude, however, are rare." (p. 29) ----excerpted from _Fundamentals_of_Clinical_Trials_ by L. M. Friedman, C. D. Furberg, & D. L. DeMets (Wright, PSG, Inc: 1982)