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Uncertainty and equipoise: at interplay between epistemology, decision making and ethics
1Center and Division for Evidence-based Medicine and Health Outcome Research, Clinical Translational Science Institute, University of South Florida, Tampa, Florida, USA. bdjulbeg@health.usf.edu
The American Journal of the Medical Sciences
|August 6, 2011
Summary
The concept of equipoise remains crucial for ethical clinical research, despite arguments for its abandonment. Understanding uncertainty through equipoise links research ethics with rational decision-making, improving choices in healthcare interventions.
Area of Science:
- Clinical Research Ethics
- Epistemology of Uncertainty
- Decision Theory
Background:
- Debate exists on abandoning equipoise in clinical research due to conflation with clinical care.
- Opponents acknowledge the need for research addressing uncertainties in healthcare interventions.
- Current proposals to abandon equipoise are contradictory given the necessity of addressing uncertainties.
Purpose of the Study:
- To demonstrate that equipoise is the most effective framework linking human experimentation theory with rational choice theory.
- To explore uncertainty (equipoise) at the intersection of epistemology, decision-making, and clinical research ethics.
- To analyze cognitive processing of uncertainties in clinical research decision-making.
Main Methods:
- Conceptual analysis of equipoise and uncertainty in clinical research.
- Examination of the relationship between epistemology, decision-making, and ethics.
- Application of dual-processing theory to understand cognitive responses to uncertainty.
Main Results:
- Proposals to abandon equipoise are invalid due to inherent contradictions.
- Equipoise remains the most useful framework for connecting clinical research and rational choice.
- Cognitive processing, influenced by dual-processing theory (System I and System II), shapes responses to uncertainty.
Conclusions:
- Understanding the intertwined relationship between uncertainty, errors, and injustice is key to wiser choices in clinical research.
- Ethics and rationality in clinical research decision-making are inseparable.
- Equipoise provides a vital framework for navigating uncertainties in human experimentation.
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