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Equipoise as a means of managing uncertainty: personal, communal and proxy

Alderson, P; (1996) Equipoise as a means of managing uncertainty: personal, communal and proxy. Journal of Medical Ethics , 22 (3) pp. 135-139. 10.1136/jme.22.3.135. Green open access

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Abstract

Equipoise is advocated as a means of achieving high scientific and ethical standards in randomised trials. As used in the context of research the word describes a state of uncertainty characterised by the belief that in a trial no arm is known to offer greater harm or benefit than any other arm. Clinicians who lack personal equipoise are advised to accept clinical or communal equipoise, based on current unresolved disagreement among the medical profession. Equipoise is mainly discussed in the literature as an issue for senior doctors and research directors. Limitations ofprofessional equipoise are reviewed, and data on the neglected topic ofpatients' equipoise are reported using the example of breast cancer trials. In theory, a patient who gives informed and voluntary consent to enter a randomised trial has achieved the equilibrium of equipoise. In practice, equipoise among patients ranges from personal to proxy acceptance.

Type: Article
Title: Equipoise as a means of managing uncertainty: personal, communal and proxy
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1136/jme.22.3.135
Publisher version: http://dx.doi.org/10.1136/jme.22.3.135
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Research ethics; equipoise; informed consent; randomised trials.
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Education
UCL > Provost and Vice Provost Offices > School of Education > UCL Institute of Education
URI: https://discovery.ucl.ac.uk/id/eprint/1483872
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