Jove
Visualize
Contact Us
JoVE
x logofacebook logolinkedin logoyoutube logo
ABOUT JoVE
OverviewLeadershipBlogJoVE Help Center
AUTHORS
Publishing ProcessEditorial BoardScope & PoliciesPeer ReviewFAQSubmit
LIBRARIANS
TestimonialsSubscriptionsAccessResourcesLibrary Advisory BoardFAQ
RESEARCH
JoVE JournalMethods CollectionsJoVE Encyclopedia of ExperimentsArchive
EDUCATION
JoVE CoreJoVE BusinessJoVE Science EducationJoVE Lab ManualFaculty Resource CenterFaculty Site
Terms & Conditions of Use
Privacy Policy
Policies

Related Concept Videos

Principle of Equivalence01:18

Principle of Equivalence

According to Albert Einstein (1897-1955), free-falling and feeling weightless are intrinsically linked. If a person were in free-fall under gravity, for example, diving towards the Earth from an airplane, they would feel completely weightless. Similarly, a person descending in a lift may feel partially weightless. Broadly speaking, it is assumed that an object in a uniform gravitational field and an object undergoing constant acceleration in the absence of gravity are under the same...
Leveling Effect and Non-Aqueous Acid-Base Solutions02:11

Leveling Effect and Non-Aqueous Acid-Base Solutions

This lesson defines the leveling effect in acidic and basic solutions and its role in aqueous and non-aqueous solutions. It is essential to understand the competing nature of various species in a chemical system.
The Leveling Effect of a Solvent
A generic acid (HA) reacts with the generic base (B-) to yield the corresponding conjugate base (A-) and conjugate acid (HB):
Equilibrium and Balance01:15

Equilibrium and Balance

The inner ear assumes dual functionalities of auditory perception and equilibrium maintenance. The vestibule is the organ responsible for balance. This organ contains mechanoreceptors, specifically hair cells, endowed with stereocilia, which aid in deciphering information regarding the position and motion of our heads. Two intrinsic components, the utricle and saccule, help perceive head position, while the semicircular canals track head movement. Neurological messages initiated in the...
Reaction Quotient02:35

Reaction Quotient

The status of a reversible reaction is conveniently assessed by evaluating its reaction quotient (Q). For a reversible reaction described by m A + n B ⇌ x C + y D, the reaction quotient is derived directly from the stoichiometry of the balanced equation as
Equilibrium Conditions for a Particle01:23

Equilibrium Conditions for a Particle

When an object is in equilibrium, it is either at rest or moving with a constant velocity. There are two types of equilibrium: static and dynamic. Static equilibrium occurs when an object is at rest, while dynamic equilibrium occurs when an object is moving with a constant velocity. In both cases, there must be a balance of forces acting on the object.
To understand the concept of equilibrium, let us first consider the forces acting on an object. When different forces act on an object, they can...
Freezing Point Depression and Boiling Point Elevation03:12

Freezing Point Depression and Boiling Point Elevation

Boiling Point Elevation
The boiling point of a liquid is the temperature at which its vapor pressure is equal to ambient atmospheric pressure. Since the vapor pressure of a solution is lowered due to the presence of nonvolatile solutes, it stands to reason that the solution’s boiling point will subsequently be increased. Vapor pressure increases with temperature, and so a solution will require a higher temperature than will pure solvent to achieve any given vapor pressure, including one...

You might also read

Related Articles

Articles linked to this work by shared authors, journal, and citation graph.

Sort by
Same author

Xenotransplantation: Injustice, Harm, and Alternatives for Addressing the Organ Crisis.

The Hastings Center report·2025
Same author

Individual difference factors that predict evaluations and acceptance of authorized concealment for the reduction of nocebo side effects.

Patient education and counseling·2025
Same author

Clinical trials are not the solution to inequities in cancer care.

Gynecologic oncology·2025
Same author

Are Patients With Cancer Best Managed in a Clinical Trial?

JAMA·2024
Same author

The Use of Authorized Concealment to Minimize Nocebo Side Effects: A Survey of US Public Attitudes.

Psychotherapy and psychosomatics·2023
Same author

Ethical Outreach for Rural Cancer Care in the United States: Balancing Access With Optimal Clinical Outcomes.

JCO oncology practice·2023
Same journal

Providers' Perspectives on Hospital-Based Tobacco Treatment Efforts.

The American journal of the medical sciences·2026
Same journal

In Memoriam: Maurice A. Mufson, MD, MACP.

The American journal of the medical sciences·2026
Same journal

Outcomes of Acute Myeloid Leukemia Patients Admitted to the Intensive Care Unit within 100 days of Allogeneic Hematopoietic Stem Cell Transplantation.

The American journal of the medical sciences·2026
Same journal

Association Between Reverse Triiodothyronine and Cardiac Complications in Patients with Uncontrolled Graves' Disease.

The American journal of the medical sciences·2026
Same journal

Chlorthalidone vs. hydrochlorothiazide in hypertension management: Lessons for guiding clinical practice.

The American journal of the medical sciences·2026
Same journal

The impact of COVID-19 on alcohol-associated hepatitis and alcohol-associated cirrhosis.

The American journal of the medical sciences·2026
See all related articles

Related Experiment Video

Updated: May 30, 2026

Automated Acoustic Dispensing for the Serial Dilution of Peptide Agonists in Potency Determination Assays
08:06

Automated Acoustic Dispensing for the Serial Dilution of Peptide Agonists in Potency Determination Assays

Published on: November 10, 2016

Dispensing with equipoise.

Franklin G Miller1

  • 1Department of Bioethics, Clinical Center, National Institutes of Health, Building 10, Room 1C118, Bethesda, MD 20892-1156, USA. fmiller@nih.gov

The American Journal of the Medical Sciences
|August 2, 2011
PubMed
Summary
This summary is machine-generated.

Equipoise, a standard for ethical clinical trials, has significant flaws, particularly in placebo-controlled studies and early termination decisions. Researchers propose abandoning equipoise for more robust ethical principles in clinical research.

More Related Videos

Reliable Mechanochemistry: Protocols for Reproducible Outcomes of Neat and Liquid Assisted Ball-mill Grinding Experiments
13:05

Reliable Mechanochemistry: Protocols for Reproducible Outcomes of Neat and Liquid Assisted Ball-mill Grinding Experiments

Published on: January 23, 2018

Vessel-sparing Excision and Primary Anastomosis
08:09

Vessel-sparing Excision and Primary Anastomosis

Published on: January 7, 2019

Related Experiment Videos

Last Updated: May 30, 2026

Automated Acoustic Dispensing for the Serial Dilution of Peptide Agonists in Potency Determination Assays
08:06

Automated Acoustic Dispensing for the Serial Dilution of Peptide Agonists in Potency Determination Assays

Published on: November 10, 2016

Reliable Mechanochemistry: Protocols for Reproducible Outcomes of Neat and Liquid Assisted Ball-mill Grinding Experiments
13:05

Reliable Mechanochemistry: Protocols for Reproducible Outcomes of Neat and Liquid Assisted Ball-mill Grinding Experiments

Published on: January 23, 2018

Vessel-sparing Excision and Primary Anastomosis
08:09

Vessel-sparing Excision and Primary Anastomosis

Published on: January 7, 2019

Area of Science:

  • Clinical Trials Ethics
  • Research Methodology
  • Medical Policy

Background:

  • Equipoise is a cornerstone principle for the ethical design and execution of randomized controlled trials.
  • This principle asserts that genuine uncertainty must exist regarding the comparative therapeutic merits of each arm of a trial.
  • However, the practical application of equipoise faces scrutiny, particularly in complex trial designs and data analysis scenarios.

Purpose of the Study:

  • To critically evaluate the ethical adequacy of the equipoise principle in contemporary clinical trials.
  • To identify specific shortcomings of equipoise, especially concerning placebo-controlled trials and early trial termination based on interim data.
  • To propose an alternative ethical framework for clinical research that better serves the goals of evidence generation for health policy.

Main Methods:

  • Conceptual analysis of the equipoise principle and its application in randomized controlled trials.
  • Examination of the "therapeutic orientation" fallacy, which conflates clinical research ethics with medical care ethics.
  • Argumentative critique of equipoise's limitations in guiding decisions on placebo use and early trial cessation.

Main Results:

  • The equipoise principle provides inadequate ethical guidance for placebo-controlled trials.
  • Equipoise fails to offer sound ethical justification for decisions to terminate trials early based on interim benefit data.
  • The "therapeutic orientation" underlying equipoise hinders its ability to support the primary goal of trials: generating evidence for health policy.

Conclusions:

  • The equipoise principle is fundamentally flawed and should be abandoned in the ethical design of clinical trials.
  • Existing principles of research ethics are sufficient to protect participants and promote valuable research without relying on equipoise.
  • A revised ethical framework is needed that prioritizes the generation of robust evidence for health policy and treatment guidelines.