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The ethics of placebo-controlled trials – a middle ground

In this thoughtful article, Emanuel and Miller outline the stances taken by those on both sides of the debate about using placebos in research. The first is that placebos should be used as a control unless this would increase the risk of death or irreversible morbidity as a result. The other view is that if an effective therapy exists then the use of a placebo group should be prohibited (the stance taken in the Declaration of Helsinki).

The authors conclude that both positions are indefensible and that a middle ground on the use of placebo-controlled trials is needed. They argue that placebo-controlled trials are permissible when proven therapies exist, but only if certain ethical and methodological criteria are met.