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Ethics of Randomized Controlled Trials: Should Economists Care about Equipoise?

Michel Abramowicz and Ariane Szafarz

No 19-017, Working Papers CEB from ULB -- Universite Libre de Bruxelles

Abstract: Equipoise is defined by Freedman (1987, p.141) as a "state of genuine uncertainty on the part of the clinical investigator regarding the comparative therapeutic merits of each arm in a trial." This principle is grounded in the ethical motivation that any ex-ante preference for a given option would undermine the interests of those who are offered another. Randomized controlled trials (RCTs) in development economics disregard the equipoise requirement by typically disadvantaging the control group. This paper investigates how the equipoise principle is formalized in the medical literature and discusses whether and how it should be taken into consideration by economists. It argues that equipoise is especially relevant when double (or even single) blindness is excluded and when the control group includes already vulnerable individuals. More generally, this paper advocates for developing a vibrant ethics conversation on the design and fairness of RCTs in social sciences.

Keywords: Equipoise; Fairness; Ethics of RCTs; Control Group; Placebo (search for similar items in EconPapers)
JEL-codes: C93 I14 B41 O16 D63 (search for similar items in EconPapers)
Date: 2019-08-26
New Economics Papers: this item is included in nep-exp, nep-hme and nep-hpe
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