Research ethics and evidence based medicine.
In this paper, the author argues that the requirement to conduct randomised clinical trials to inform policy in cases where one wants to identify a cheaper alternative to known effective but expensive interventions raises an important ethical issue. This situation will eventually arise whenever there are resource constraints, and a policy decision has been made not to fund an intervention on cost effectiveness grounds. It has been thought that this is an issue only in extremely resource poor settings. This paper gives an example from the United Kingdom illustrating that this is also a problem faced by richer countries.
Lie
R K
RK
Department of Clinical Bioethics, National Institutes of Health, Bethesda, MD 20852, USA. reidar.lie@fil.uib.no
D035061:Control Groups; D003362:Cost-Benefit Analysis / Q000941:ethics; D003695:Delivery of Health Care / Q000191:economics / Q000941:ethics; D032984:Ethics, Research; D019317:Evidence-Based Medicine / Q000941:ethics*; D015276:Health Care Rationing / Q000941:ethics / Q000379:methods; D006801:Humans; D007371:Interferon-gamma / Q000627:therapeutic use; D009103:Multiple Sclerosis / Q000188:drug therapy; D011366:Professional Review Organizations / Q000941:ethics; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic / Q000941:ethics*; D012107:Research Design / Q000592:standards; D013222:State Medicine / Q000191:economics / Q000941:ethics; D006113:United Kingdom
D007371:Interferon-gamma