What is equipoise in clinical trials? Real uncertainty among medical experts about which treatment works best. Why is equipoise important for clinical trials? It ensures that trials are ethical and that patients are not knowingly given inferior treatments. What happens if researchers know one treatment is clearly better? It is unethical to randomize patients, as it would harm them. What is individual equipoise? A single doctor is unsure about which treatment is better. What is clinical equipoise? The medical community as a whole is unsure about which treatment is superior. What did Freedman argue about the old view of equipoise? He argued that it is acceptable for individual doctors to have preferences as long as the expert community disagrees overall. When must a clinical trial stop? When strong evidence shows that one treatment is better than the others. What are multi-arm trials? Trials that compare multiple treatments, requiring equipoise among all options. What tension exists in clinical trials regarding patient care? The tension between the need for randomization in research and the desire to provide the best care for patients. What is the response to critics who say equipoise slows research? Freedman argues that ethics is more important than the speed of research. What is the problem with randomization starting at the first patient? It can be difficult due to changing opinions and preferences of doctors throughout the trial. What is the 'counsel of desperation' according to Freedman? Suggestions to abandon equipoise for the sake of advancing medical knowledge. What does Marquis suggest regarding participation in clinical trials? He suggests a new kind of ethics that forces people into participating in medical research. What is theoretical equipoise? A perfect balance between two treatments, which is unrealistic due to inherent biases. How does Freedman view theoretical equipoise? He believes it is fragile and can be easily disrupted by any evidence or instinct. What is the bottom line rule for ethical trials according to Freedman? Only conduct trials when experts truly do not know which treatment is best. What happens if a trial lacks equipoise? The trial can collapse and fail, as seen in the breast cancer trial example. What is the significance of the breast cancer trial mentioned? It was stopped because the researchers were not in a state of equipoise. What is the ethical concern with giving patients inferior treatment? It is considered unethical to knowingly provide a treatment that is believed to be worse. What is the role of the medical community in establishing equipoise? The community must have honest disagreements about the effectiveness of treatments. What does Freedman say about the ethics of research? Ethics should never be sacrificed for faster results in clinical trials. What is the impact of personal opinions on clinical trials? Personal opinions can create bias and affect the ethical nature of trials. What is the challenge of maintaining equipoise during a trial? It can be difficult due to the evolving nature of medical knowledge and opinions. What is the ethical implication of abandoning equipoise? It risks losing the moral foundation necessary for conducting ethical trials. What does Freedman suggest about overly neat trials? They should only be conducted if experts are truly uncertain about treatment effectiveness. What is the consequence of having a clear preference among doctors? It can render a trial unethical if there is a consensus on which treatment is superior. What is the importance of randomization in clinical trials? It ensures fairness and helps eliminate bias in treatment assignment. What is one potential problem with patient consent in trials? Patients may refuse what the physician considers the best treatment.
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