To the Editor: I have a number of concerns
about the article by Mr Halpern and colleagues.1 First,
much of their argument is based on "exposure of participants to the risks
and burdens of human research." On the contrary, I believe that RCTs should
be carried out when there is equipoise; ie, when the treatments being compared
are equally likely to be beneficial. Randomized trials under this condition
(at least when the comparator treatments are otherwise widely available) simply
extend the patient's choice.2 The premise
that patients somehow make a sacrifice for the common good when they participate
in a trial is therefore wrong.
Lilford RJ. The Ethics of Underpowered Clinical Trials. JAMA. 2002;288(17):2118–2119. doi:10.1001/jama.288.17.2118
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