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Equipoise, knowledge and ethics in clinical research and practice.

Richard Ashcroft

|October 20, 2001

Summary

Clinical trial ethics require equipoise, or cognitive indifference between treatments. While recent epistemological work offers insights, the concept of equipoise remains fundamentally incoherent despite its importance in justifying trials.

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Area of Science:

Medical Ethics
Clinical Trial Design
Epistemology

Background:

Ethical clinical trials necessitate equipoise, defined as cognitive indifference regarding treatment efficacy.
Equipoise is considered essential for beneficence, non-maleficence, and fairness in randomized treatment assignments.
The precise definition and application of equipoise, including whose perspective matters, remain subjects of debate.

Purpose of the Study:

To examine recent epistemological reconstructions of equipoise-like concepts.
To assess the success of these reconstructions in understanding equipoise cognitively.
To evaluate the coherence of equipoise as a justification for clinical trials.

Main Methods:

Analysis of recent work in epistemology related to equipoise.

Keywords:

Analytical Approach Biomedical and Behavioral Research

Related Experiment Videos

Critical examination of cognitive theories of equipoise.

Discussion of the social management versus cognitive significance of equipoise judgments.

Main Results:

Recent epistemological work provides promising avenues for understanding equipoise cognitively.
Despite progress, current reconstructions of equipoise are deemed insufficient.
Equipoise, while the leading theory for clinical trial justification, is identified as incoherent.

Conclusions:

Further development is needed to refine the cognitive understanding of equipoise.
The concept of equipoise, as currently formulated, presents significant theoretical challenges.
Despite its incoherence, equipoise remains the most influential framework for the ethical justification of clinical trials.