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Concluding Reflections 

Concluding Reflections
Chapter:
Concluding Reflections
Source:
Medical Experimentation: Personal Integrity and Social Policy: New Edition
Author(s):

Charles Fried

DOI:
10.1093/med/9780190602727.003.0009

More than 40 years after the publication of Medical Experimentation, the randomized clinical trial (RCT) has become the gold standard for testing medical hypotheses, bringing medical science closer in line with science generally, but the ethical dilemmas remain and are if anything aggravated. The concept of equipoise still is only a partial escape. What has changed has been the institutional context of the practice of medicine, blurring the lines between practitioners and health bureaucrats—perhaps to the benefit of the overall health of the population. Finally, it is asked whether there have been rigorously controlled trials of the efficiency and efficacy of RCTs compared to alternatives such as case-controlled and retrospective studies.

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