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

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  • Michel Abramowicz
  • Ariane Szafarz

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.

Suggested Citation

  • Michel Abramowicz & Ariane Szafarz, 2019. "Ethics of Randomized Controlled Trials: Should Economists Care about Equipoise?," Working Papers CEB 19-017, ULB -- Universite Libre de Bruxelles.
    • Handle: RePEc:sol:wpaper:2013/292092
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    References listed on IDEAS

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    More about this item

    Keywords

    Equipoise; Fairness; Ethics of RCTs; Control Group; Placebo;
    All these keywords.

    JEL classification:

    • C93 - Mathematical and Quantitative Methods - - Design of Experiments - - - Field Experiments
    • I14 - Health, Education, and Welfare - - Health - - - Health and Inequality
    • B41 - Schools of Economic Thought and Methodology - - Economic Methodology - - - Economic Methodology
    • O16 - Economic Development, Innovation, Technological Change, and Growth - - Economic Development - - - Financial Markets; Saving and Capital Investment; Corporate Finance and Governance
    • D63 - Microeconomics - - Welfare Economics - - - Equity, Justice, Inequality, and Other Normative Criteria and Measurement

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