Abstract
We should recognise that when we do not know we must say so, mean what we say, and somehow make time to understand and be understood. When secretly we think we already know what is best before we have evidence, we deceive ourselves, create ethical dilemmas where none need exist, and continue repeatedly to put millions at marginal risks which may outweigh substantial benefits for a few. In a well designed trial, randomisation to either arm is a gain, because the placebo and Hawthorne effects are real. They depend not on deception, but the promise of care in its widest sense. Participation in trials seems to ensure more real professional fulfillment of this promise than most patients get from conventional practice. Mainly for this reason, recruits consistently enjoy better outcomes than nonrespondents in all published trials, and respondents generally receive better care than non-respondents.
- Copyright © 1994 by the American Academy of Pediatrics
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