The American journal of the medical sciences
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In recent years, various authors have proposed that the concept of equipoise be abandoned because it conflates the practice of clinical care with clinical research. At the same time, the equipoise opponents acknowledge the necessity of clinical research if there are unresolved uncertainties about the effects of proposed healthcare interventions. As equipoise represents just 1 measure of uncertainty, proposals to abandon equipoise while maintaining a requirement for addressing uncertainties are contradictory and ultimately not valid. ⋯ This approach is based on the view that considerations of ethics and rationality cannot be separated. I analyze the response to uncertainties as it relates to the dual-processing theory, which postulates that rational approach to (clinical research) decision making depends both on analytical, deliberative processes embodied in scientific method (system II), and good human intuition (system I). Ultimately, our choices can only become wiser if we understand a close and intertwined relationship between irreducible uncertainty, inevitable errors and unavoidable injustice.
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Review Historical Article
From laboratory to bedside: ethical, legal and social issues in translational research.
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Opposition to the use of animals in biomedical research rests on diverse scientific and ethical arguments. Here I offer a response to key objections and argue that the responsible use of animals in biomedical research with the goal of advancing medical knowledge, science and human health, is scientifically and morally justified. ⋯ Thus, I hope this personal perspective persuades other scientists, public health officials, scientific organizations and our academic leadership to join the debate and invites opponents of animal research to create an atmosphere where civil discourse can take place, free of threats and intimidation. The public deserves an open and honest debate on this important topic.