A partial defense of clinical equipoise

摘要

In this essay, I suggest that a slightly modified version of Freedman’s formulation of the clinical equipoise requirement is justified. I begin this essay with a brief discussion of the equipoise requirement. In the second and third sections, I discuss several objections to the clinical equipoise requirement as well as two attempts to justify the equipoise requirement. In the fourth section, in order to gain some insight into what it means to say that a physician has an obligation to act in the best interest of her patient, I examine a similar obligation, namely, a parent’s obligation to act in her child’s best interest. I claim that there are several uncontroversial exceptions to this obligation, and these exceptions arise when a parent occupies a role more complex than the role of parent simpliciter. In the fifth section, I explore whether the exceptions to a parent’s obligation to act in her child’s best interest may shed light on some exceptions to a physician–researcher’s obligation to act in the best interest of her patient. These exceptions, I suggest, arise when a physician occupies a role more complex than physician simpliciter, and they ground a permission to conduct randomized clinical trials, even if doing so is not in the best interest of a physician–researcher’s patients. I furthermore claim that these exceptions provide justification for a modified formulation of the clinical equipoise requirement.