Journal of Medicine and Philosophy 25 (4):399 – 426 (2000)

Fred Gifford
Michigan State University
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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DOI 10.1076/0360-5310(200008)25:4;1-A;FT399
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Uncertainty and the Ethics of Clinical Trials.Sven Ove Hansson - 2006 - Theoretical Medicine and Bioethics 27 (2):149-167.
Clinical Equipoise: Actual or Hypothetical Disagreement?Scott Gelfand - 2013 - Journal of Medicine and Philosophy 38 (6):590--604.
Equipoise and the Criteria for Reasonable Action.Emily L. Evans & Alex John London - 2006 - Journal of Law, Medicine and Ethics 34 (2):441-450.
Evidence-Based Equipoise and Research Responsiveness.Scott D. Halpern - 2006 - American Journal of Bioethics 6 (4):1 – 4.

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