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A fundamental ethical problem in statistics

Question

A fundamental ethical problem in statistics arises in experimentation (i.e., in the context of studies of

experimental drugs for treating AIDS). On one side, organizations such as the National Institute of Health insist on randomly assigning treatments such as flipping a coin for each patient to decide which treatment to assign. The advantage of randomized experiments is that they allow reliable conclusions without the need to worry about lurkingvariables. However, some groups of AIDS patients have opposed randomization, instead making the argument that each patient should be assigned the best available treatment (or to be more precise, whatever treatment is currently believed to be the best). The ethical dilemma is to balance the benefits to the patients in the study (who would like the opportunity to choose among available treatments) with future patients (who would be served by learning as soon as possible about the effectiveness of the competing treatments). The issue is complicated. On one hand, the randomized study is most trustworthy if all the patients in the study participate. If they are not treated respectfully, the patients might go outside the study and try other drugs, which could bias the estimates of treatment effects. On the other hand, the patients might benefit from being in an experimental study. Even if the treatment is randomized, the patients are getting close medical attention from the researchers. Current best practice is to design studies so that all subjects will be expected to benefit in some way, but still keeping the randomized element. For example, a study can compare two potentially beneficial experimental treatments, rather than comparing a treatment to an inert “control.” However, there will always be conflicts of interest between the patients in the study, the scientists conducting it, and the public at large. In your original post, compare and contrast at least two research designs that might be used to research life threatening diseases/disorders. At least one design should present ethical issues and at least one design should minimize potential ethical issues. Provide at least one Scripture passage that supports your ethical perspectives on medical/public health research.

 
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