Abstract

In their essay, ‘When Clinical Trials Compete: Prioritizing Study Recruitment’, Gelinas et al describe a collective action problem that can arise if multiple trials at a single institution are all trying to recruit participants from the same patient population. Each trial may be addressing an important question, and each will need a certain number of participants to provide an informative answer. But because these trials are all recruiting from the same population, it is possible that there will not be enough participants to go around. It may turn out, then, that none successfully achieves its target sample size and all end up being uninformative or less informative than hoped. As Gelinas et al observe, these kinds of uninformative or less-informative trials are ethically problematic, since they fail to fully redeem participant risks and burdens with adequate gains in generalisable knowledge. Such trials also represent wasteful or inefficient research activities, since each necessarily has a human and material cost, but then fails to offset these costs by providing a definitive answer to the research …