To the Editor.—
I read with considerable interest the editorial by Dr Peter P. Morgan1 entitled "Randomized Clinical Trials Need to be More Clinical." I was somewhat amazed with the author's comment that a "randomized clinical trial requires clinicians to set aside their own judgments, asks patients to accept treatment that may be substandard,..." I have been a clinical investigator in several randomized trials. If I had believed I was asking a patient to accept substandard treatment, or had already made a judgment that I had "set aside" regarding any treatment modality, I would have felt obliged not to participate in that clinical trial.It is unethical, immoral, and unconscionable to encourage patients to accept any treatment a physician thinks is substandard.
Sautter RD. Randomized Clinical Trials. JAMA. 1985;254(8):1032–1033. doi:10.1001/jama.1985.03360080042011