A critique of clinical equipoise: Therapeutic misconception in the ethics of clinical trials

Howard Brody

Research output: Chapter in Book/Report/Conference proceedingChapter


This chapter explores the theoretical and practical problems associated with the similarity position and its logical offspring, clinical equipoise. It first considers the therapeutic misconception in the ethics of clinical trials before turning to the ethical distinction between research and therapy. It then turns to Charles Fried's arguments regarding the similarity position within bioethics, with particular emphasis on his assertion that answers to ethical dilemmas in research would have to be found within the ethics of therapeutic medicine. It also looks at the emergence of clinical equipoise as a doctrine in research ethics, along with the divorce between theory and practice as exemplified by placebo-controlled trials. The chapter concludes by launching a critique of the similarity position and clinical equipoise and calling for an alternative framework for the ethics ofclinical trials.

Original languageEnglish (US)
Title of host publicationThe Ethical Challenges of Human Research
Subtitle of host publicationSelected Essays
PublisherOxford University Press
ISBN (Electronic)9780190267681
ISBN (Print)9780199896202
StatePublished - Nov 15 2012
Externally publishedYes


  • Bioethics
  • Charles fried
  • Clinical equipoise
  • Clinical trials
  • Placebo-controlled trials
  • Research
  • Research ethics
  • Similarity position
  • Therapeutic medicine
  • Therapy

ASJC Scopus subject areas

  • General Arts and Humanities


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