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Related Experiment Videos

Rehabilitating equipoise.

Paul B Miller1, Charles Weijer

  • 1University of Toronto, Canada.

Kennedy Institute of Ethics Journal
|October 23, 2003
PubMed
Summary
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Physicians can enroll patients in randomized clinical trials (RCTs) when they lack certainty about the best treatment (Fried

Area of Science:

  • Medical Ethics
  • Clinical Research

Background:

  • The ethical justification for enrolling patients in randomized clinical trials (RCTs) is debated.
  • Two key concepts, Fried's equipoise (FE) and clinical equipoise (CE), are central to this discussion.

Purpose of the Study:

  • To analyze the distinct ethical contributions of Fried's equipoise (FE) and clinical equipoise (CE).
  • To demonstrate that FE and CE are not competing but complementary ethical standards for RCTs.

Main Methods:

  • Conceptual analysis of the ethical literature on equipoise.
  • Distinguishing the roles of physician-patient fiduciary duties and community professional standards.

Main Results:

  • Fried's equipoise (FE) addresses the physician's duty to the individual patient.
Keywords:
Analytical ApproachBiomedical and Behavioral Research

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  • Clinical equipoise (CE) establishes a standard for the broader research community and institutional review boards.

    • Conclusions:

    • FE and CE offer separable justifications for conducting clinical trials.
    • Both FE and CE are necessary, though incomplete on their own, for the ethical conduct of RCTs.