title: What is the best standard for the standard of care in clinical research?
abstract: During the past decennium, one of the main issues discussed in research ethics has been focused on the care that should be provided to the control group in a clinical trial. This discussion is also called the standard of care debate. Current international research ethics guidelines contain a wide variety of standards for the standard of care--including the provision of the highest attainable, the best available, the best current, a proven, and an established effective treatment. In this article, we systematically review the currently used standards and argue that none of the current standards is adequate to serve as a universal standard for the standard of care. Alex London has made a substantial proposal for a universal standard, but universally adopting his standard is problematic. In this article, we propose a revised version of London's standard.
authors.affiliation: Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands. r.vandergraaf@umcutrecht.nl
authors.forename: Rieke
authors.initials: R
authors.lastname: van der Graaf
authors.forename: Johannes J M
authors.initials: JJ
authors.lastname: van Delden
mesh_terms: D019380:Anti-HIV Agents / Q000008:administration & dosage; D035061:Control Groups; D019049:Developed Countries; D003906:Developing Countries; D004334:Drug Administration Schedule; D032984:Ethics, Research; D017408:Guidelines as Topic / Q000592:standards; D015658:HIV Infections / Q000517:prevention & control / Q000635:transmission; D006801:Humans; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control; D038622:Internationality; D011787:Quality of Health Care; D016032:Randomized Controlled Trials as Topic / Q000941:ethics* / Q000592:standards*; D012107:Research Design; D015215:Zidovudine / Q000008:administration & dosage
chemical_list: D019380:Anti-HIV Agents; D015215:Zidovudine