The ethics of non-inferiority trials.

摘要

Silvio Garattini and Vittorio Bertele' (Dec 1, p 1875) argue that non-inferiority trials "have no ethical justification, sincethey do not offer any possible advantage...to patients".Their conclusion is based on the traditional ethic of physicians whereby advocacy for each patient's best interest must supersede all other considerations. However, this ethic only applies to a world where resources for health care are endless and hence do not matter. Yet in a world of limited resources, this ethic can lead to unfair practices, with some patients getting full access to services and others getting none.