The ethics of randomised controlled trials from the perspectives of patients, the public, and healthcare professionals

Abstract

Since the introduction of randomised controlled trials, professionals and lay people alike have worried over whether doing this sort of experiment in humans is ethical. It has been argued that participants may be called to sacrifice their own best interests for the benefit of future patients.1 The scientific rationale for conducting a trial rests in collective equipoise, which means that the medical community as a whole is genuinely uncertain over which treatment is best. The key point, however, is that future patients benefit at no cost to participants, provided that participants are in personal equipoise and give informed consent on this basis. In these circumstances, the trial arms are an equally good bet prospectively.2 ### Summary points To find out what patients, the general public, and healthcare professionals thought about trials, we undertook a review of the ethics of randomised controlled trials from these perspectives as part of a broader review relating to the ethics of designing and conducting clinical trials.1 We searched BIDS, Medline, and Psychlit (for strategy see the BMJ website). There were 61 studies on attitudes …