Evidence and ethics in medicine.

Area of Science:

• Medical Ethics
• Epistemology
• Clinical Trials

Background:

• The relationship between ethics and epistemology in medicine is often underestimated.
• Clinical trials present complex ethical challenges.
• Extracorporeal membrane oxygenation (ECMO) for persistent pulmonary hypertension of the newborn serves as a case study.

Purpose of the Study:

• To investigate the intricate connection between ethical considerations and epistemological judgments in medical research.
• To demonstrate how ethical issues in clinical trials are intrinsically linked to the evaluation of evidence.

Main Methods:

• A case study approach focusing on clinical trials of extracorporeal membrane oxygenation (ECMO).
• Analysis of three key ethical issues: trial permissibility, mandatory stopping rules, and informed consent.
• Examination of the relationship between these ethical issues and epistemological assessments of evidence.

Main Results:

• Ethical issues in ECMO trials are deeply intertwined with epistemological judgments about the weight of evidence.
• Decisions regarding trial permissibility, stopping rules, and informed consent necessitate careful consideration of evidential standards.

Conclusions:

• Informed ethical decision-making in medical research requires a thorough understanding of epistemological factors.
• Ethical conclusions cannot be reached without first addressing the evidential and epistemological underpinnings of the research.