Freedman's 'Clinical Equipoise' and Sliding-Scale All-Dimensions-Considered Equipoise'  

Oleh:

Gifford, Fred

Jenis: Article from Journal - ilmiah internasional
Dalam koleksi: The Journal of Medicine and Philosophy vol. 25 no. 4 (Aug. 2000), page 399-426.
Topik: Clinical Equipoise; Clinical Trials; Community Equipoise; Equipoise; Fastidious
Fulltext: MM80V25N4P399.pdf (100.99KB)

Ketersediaan

Perpustakaan Pusat (Semanggi) Nomor Panggil: MM80.10 Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

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It is often claimed that a clinical investigator may ethically participate (e.g., enroll patients) in a trial only if she is in equipoise (if she has no way to ground a preference for one arm of the study). But this is a serious problem, for as data accumulate, it can be expected that there will be a discernible trend favoring one of the treatments prior to the point where we achieve the trial's objective. In this paper, I critically evaluate Benjamin Freedman's 'clinical equipoise' solution to this dilemma. I argue that Freedman actually puts forth at least two distinct contrasts - one in terms of community vs. individual equipoise, and another concerning clinical vs. theoretical equipoise - and that neither of them resolves the dilemma. I then make a proposal for a more adequate account of how to think about the circumstances under which entering subjects in trials would be justified - a 'sliding-scale equipoise' that arises out of a discussion of patients' values.

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