Clinical Equipoise and Moral Leeway: An Epistemological Stance

Topoi 38 (2):447-456 (2019)
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Abstract

Clinical equipoise has been proposed as an ethical principle relating uncertainty and moral leeway in clinical research. Although CE has traditionally been indicated as a necessary condition for a morally justified introduction of a new RCT, questions related to the interpretation of this principle remain woefully open. Recent proposals to rehabilitate CE have divided the bioethical community on its ethical merits. This paper presents a new argument that brings out the epistemological difficulties we encounter in justifying CE as a principle to connect uncertainty and moral leeway in clinical ethics. The argument proposes, first, that the methodology of hypothetical retrospection is applicable to the RCT design and that it can accommodate uncertainty. As currently understood, however, HR should give up its reliance on the assumption of uncertainty transduction, because the latter assumes the principle of indifference, which does not accommodate uncertainty in the right way. The same principle is then seen to distort also the received interpretations of CE.

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Author's Profile

Daniele Chiffi
Politecnico di Milano

References found in this work

Laws and Symmetry.Bas C. Van Fraassen - 1989 - Oxford, England: Oxford University Press.
Risk, Uncertainty and Profit.Frank Knight - 1921 - University of Chicago Press.
The Philosophy of Evidence-Based Medicine.Jeremy Howick - 2011 - Wiley-Blackwell, Bmj Books.
Laws and Symmetry.Bas C. van Fraassen - 1989 - Revue Philosophique de la France Et de l'Etranger 182 (3):327-329.

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