BMJ 2001;322:795 ( 31 March )

Letters

Uncertainty about clinical equipoise

    Clinical equipoise and the uncertainty principles both require further scrutiny
    Equipoise and uncertainty principle are not mutually exclusive
    There is another exchange on equipoise and uncertainty

Clinical equipoise and the uncertainty principles both require further scrutiny

The first 150 words of the full text of this article appear below.

EDITORThe exchange between Weijer et al and Enkin addresses the question of under what circumstances and for what reasons entering patients in clinical trials can be morally justified.¹ It is important to see, however, that the issues are a good deal more complicated. There are problems on both sides, but I will focus on clinical equipoise.

This concept inadvertently conflates two distinct concepts, and neither one provides a convincing resolution of the moral dilemma posed by clinical trials. ^{2 3} Most of the essay by Weijer et al focuses on just one of these, which should really be termed "community equipoise" (the situation where not all within the community of "experts" have come to agreement that one treatment is superior to another). Enkin raises one problem with this criterion: that it fails to take seriously the clinical and moral judgment of the individual physician. But a closer look at community . . . [Full text of this article]

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