Policy equipoise and interventional superiority

Douglas MacKay

Journal of Development Effectiveness, 2024, vol. 16, issue 3, 317-331

Abstract: According to the norm of policy equipoise, it is permissible to randomly assign participants to two or more interventions in a public policy randomised controlled trial (RCT) when there is meaningful uncertainty among the relevant expert community regarding which intervention is superior. While this norm is gaining traction in the research ethics literature, the idea of interventional superiority remains unclear. Is one intervention superior to another if it is reasonably expected to more effectively realise one outcome of interest, even though there is uncertainty regarding other outcomes of interest? Or, must an intervention be reasonably expected to more effectively realise all outcomes of interest? I address this question in this paper. My aim is to develop and defend an account of interventional superiority for policy RCTs that are authorised, funded, or conducted by government institutions. I defend the greatest value view, according to which one intervention is superior to another if and only if it is reasonably expected to more effectively realise a set of outcomes with greater value.

Date: 2024
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DOI: 10.1080/19439342.2024.2346895

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