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Correspondence
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Volume 346:382-383 January 31, 2002 Number 5
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The Ethics of Placebo-Controlled Trials

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To the Editor: Emanuel and Miller (Sept. 20 issue)1 characterize the current debate about placebo-controlled trials as a debate between two orthodoxies: placebo orthodoxy and active-control orthodoxy. We used the term "placebo orthodoxy" to describe the widely held but incorrect view that the use of a placebo control is always better than the use of an active control.2,3 Labeling our position "active-control orthodoxy" wrongly suggests that we believe that "if an effective therapy exists, the use of a placebo should be prohibited" in all cases.1 We do, however, represent a clinical-equipoise orthodoxy in believing that therapeutic interventions in research must . . . [Full Text of this Article]

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