Self-study
The following passage is based on an article published in 1987.
P1
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Intro topic ·
Problems arise in comparative clinical studies of medical treatments
These trials involve withholding one or more treatments from at least one group of patients. This creates ethical issues.
Traditional standard ·
Equipoise (no opinion)
The traditional view is that doctors participating in comparative clinical trials shouldn't have an opinion about which treatment is more effective
P2
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Author's perspective ·
Theoretical equipoise is too strict, because researchers will usually have an opinion
Even if at the start a doctor thinks both treatments are equal, as the study continues, it's likely that doctors will develop an opinion about which is better.
P3
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Author's proposal ·
Clinical equipoise
Many trials are done to resolve a conflict in the expert community about what treatment is best for a given illness. Experts can be honestly divided about which is better.
P4
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Elaborate on clinical equipoise ·
As long as there's no expert consensus, the trial is OK
If there's no consensus among experts about which treatment is better, it's OK to do the trial. And it's OK for researchers to have an opinion about which is better.
Passage Style
Critique or debate
Problem-analysis
21.
The author's argument in the █████ ███ ██████ ██████████ █████ ██ ████ ████████ ██ █████ ███ ██ ███ █████████ ████ █████
a
In most comparative ████████ ███████ ███ ████ ███████ ██ ██ █████ ████████████ ████ █ █████████ ██████████ ████ ██ █ █████████ ██ ████████ ███████ ██ ██ ████ ████████ ██ ███ ███████████ █████ ███████
This undermines the author’s position, because
b
Physicians participating in ███████████ ████████ ██████ ██████ ███ ██ █████ ███ ██████ ███████ █████ ████ ██████ ███ ██ ███ ██████████ █████ ██████ ████ ████████
What physicians ask doesn’t undermine the author’s position. What matters is whether clinical equipoise is a good standard to use and whether it would help solve the problem of theoretical equipoise. What doctors ask to do doesn’t affect whether trials do or do not meet ethical standards. We’re concerned with what doctors should be doing, not what they actually do.
c
The number of ███████████ ████████ ██████ ████ ███ █████████ ████████ ██ ██████████ ████████ ███ ███ █████ ██ ███████ █████████ ██ █████ ██████ ██ ███████████
This doesn’t undermine the argument. It just means that there are more trials and ethical oversight is needed. But it doesn’t help suggest clinical equipoise shouldn’t be adopted.
d
Medical ethicists are ████ ████████ ████ ███ ████████ ███████████ ██ █████ ██ ███████ ███████████ █████ ██ ███████████ █████████ ████ ███ █████ ██ ████████ ██████████
What ethicists prefer compared to researchers doesn’t undermine the argument. The author’s argument is based on reasons she believes clinical equipoise is appropriate. Whether other people prefer clinical equipoise doesn’t affect the argument, because it doesn't engage with the reasoning of the author’s argument.
e
In clinical trials █████████ ███ ███████████ ██ ██████ ██████ ████ ███████████ ███ █████ ███ █████ ████ ██ ██████████ ███ ██████ ██ ███ ██████████ █████ ███████ █ ██████ ██████████ ██ ███ █████ ██ ████ ████████ █████ ██ ███ ██████
Even if (E) were true, this doesn’t suggest that theoretical equipoise isn’t as strict as the author claims. Doctors can still develop a preference for one treatment over another even if it’s not a strong preference. Or they could develop a preference based on data later in the study.