Giving medicine a fair trial

摘要

Evidence based medicine requires clinical trials, but these are often hampered by a misunderstanding of the relation between controlled experiment and "routine" health care. The debate in research ethics should now focus on the usability of clinical trial evidence and the fairness of the design and timing of trials. What do patients want from doctors in the way of treatment? Only what is best for them as individuals. Doctors want and intend the same for their patients. Sometimes there is uncertainty about which treatment is best Which to choose? And how? Suppose we are considering not one patient but many. Does this make any difference?