Controlled Clinical Trials and Medical Ethics

Anthroposophic vs. conventional therapy of acute respiratory and ear infections

“…However, no concurrent comparison with conventional therapy has been undertaken. Because of strong treatment preferences and ethical considerations, randomisation has traditionally been rejected in AM [51]. On the other hand, a non-randomised comparison of patients choosing treatment by anthroposophic or conventional physicians, adjusting for relevant baseline differences, would seem ethically justifiable and feasible.…”

54. Kontroverse Standpunkte bei der Anwendung von historischen Kontrollen: Gibt es ein Alles- oder Nichts-Gesetz?

“…Diese Kontroverse wird nicht nur zwischen Klinikern und Statistikern ausgetragen, sondern unter den Statistikern selbst [1,3,5,11]. Von den einen als unwissenschaftlich kategorisch abgelehnt, wird den historischen Kontrollen von anderen Autoren ein fester Platz bei klinischen Studien einger/iumt [4,10,[12][13][14]19].…”

Placebos and other comparative treatments.

“…Almost all these papers, especially that by Feinstein ( 1 980), contain useful comments and are worth reading. However, a number of predominantly continental authors, including at least one Professor of Criminal Law, have vigorously attacked the laboriously established principles of the clinical trial on ethical grounds (see Burkhardt & Kienle, 1978, for a review of their position). However, because many bad trials have been carried out, it does not mean that clinical trials are intrinsically unethical; because, in some, placebo may have been incorrectly used it does not follow that the use of placebo is never permissible.…”