IDEAS home Printed from https://ideas.repec.org/p/sol/wpaper/2013-292092.html
   My bibliography  Save this paper

Ethics of Randomized Controlled Trials: Should Economists Care about Equipoise?

Author

Listed:
  • Michel Abramowicz
  • Ariane Szafarz

Abstract

Equipoise is defined by Freedman (1987, p.141) as a "state of genuine uncertainty on the part of the clinical investigator regarding the comparative therapeutic merits of each arm in a trial." This principle is grounded in the ethical motivation that any ex-ante preference for a given option would undermine the interests of those who are offered another. Randomized controlled trials (RCTs) in development economics disregard the equipoise requirement by typically disadvantaging the control group. This paper investigates how the equipoise principle is formalized in the medical literature and discusses whether and how it should be taken into consideration by economists. It argues that equipoise is especially relevant when double (or even single) blindness is excluded and when the control group includes already vulnerable individuals. More generally, this paper advocates for developing a vibrant ethics conversation on the design and fairness of RCTs in social sciences.

Suggested Citation

  • Michel Abramowicz & Ariane Szafarz, 2019. "Ethics of Randomized Controlled Trials: Should Economists Care about Equipoise?," Working Papers CEB 19-017, ULB -- Universite Libre de Bruxelles.
  • Handle: RePEc:sol:wpaper:2013/292092
    as

    Download full text from publisher

    File URL: https://dipot.ulb.ac.be/dspace/bitstream/2013/292092/3/wp19017.pdf
    File Function: Œuvre complète ou partie de l'œuvre
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Angus Deaton, 2010. "Instruments, Randomization, and Learning about Development," Journal of Economic Literature, American Economic Association, vol. 48(2), pages 424-455, June.
    2. Alfredo Di Tillio & Marco Ottaviani & Peter Norman Sørensen, 2017. "Persuasion Bias in Science: Can Economics Help?," Economic Journal, Royal Economic Society, vol. 127(605), pages 266-304, October.
    3. Esther Duflo & Michael Greenstone & Raymond Guiteras & Thomas Clasen, 2015. "Toilets Can Work: Short and Medium Run Health Impacts of Addressing Complementarities and Externalities in Water and Sanitation," NBER Working Papers 21521, National Bureau of Economic Research, Inc.
    4. Howard White, 2013. "An introduction to the use of randomised control trials to evaluate development interventions," Journal of Development Effectiveness, Taylor & Francis Journals, vol. 5(1), pages 30-49, March.
    5. Morvant-Roux, Solène & Guérin, Isabelle & Roesch, Marc & Moisseron, Jean-Yves, 2014. "Adding Value to Randomization with Qualitative Analysis: The Case of Microcredit in Rural Morocco," World Development, Elsevier, vol. 56(C), pages 302-312.
    6. Christopher B. Barrett & Michael R. Carter, 2010. "The Power and Pitfalls of Experiments in Development Economics: Some Non-random Reflections," Applied Economic Perspectives and Policy, Agricultural and Applied Economics Association, vol. 32(4), pages 515-548.
    7. Abhijit V. Banerjee & Esther Duflo, 2009. "The Experimental Approach to Development Economics," Annual Review of Economics, Annual Reviews, vol. 1(1), pages 151-178, May.
    8. Orazio Attanasio & Britta Augsburg & Ralph De Haas & Emla Fitzsimons & Heike Harmgart, 2015. "The Impacts of Microfinance: Evidence from Joint-Liability Lending in Mongolia," American Economic Journal: Applied Economics, American Economic Association, vol. 7(1), pages 90-122, January.
    9. Stéphane J. Baele, 2013. "The ethics of New Development Economics: is the Experimental Approach to Development Economics morally wrong?," The Journal of Philosophical Economics, Bucharest Academy of Economic Studies, The Journal of Philosophical Economics, vol. 7(1), November.
    10. Jessica Cohen & Pascaline Dupas, 2010. "Free Distribution or Cost-Sharing? Evidence from a Randomized Malaria Prevention Experiment," The Quarterly Journal of Economics, Oxford University Press, vol. 125(1), pages 1-45.
    11. Alessandro Tarozzi & Aprajit Mahajan & Brian Blackburn & Dan Kopf & Lakshmi Krishnan & Joanne Yoong, 2014. "Micro-loans, Insecticide-Treated Bednets, and Malaria: Evidence from a Randomized Controlled Trial in Orissa, India," American Economic Review, American Economic Association, vol. 104(7), pages 1909-1941, July.
    12. Kass, N.E., 2001. "An ethics framework for public health," American Journal of Public Health, American Public Health Association, vol. 91(11), pages 1776-1782.
    13. Rabin, Matthew, 1993. "Incorporating Fairness into Game Theory and Economics," American Economic Review, American Economic Association, vol. 83(5), pages 1281-1302, December.
    14. Laura Camfield & Maren Duvendack & Richard Palmer‐Jones, 2014. "Things you Wanted to Know about Bias in Evaluations but Never Dared to Think," IDS Bulletin, Blackwell Publishing, vol. 45(6), pages 49-64, November.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Michael Grimm & Jörg Peters, 2012. "Improved Cooking Stoves that End up in Smoke?," RWI Positionen, Rheinisch-Westfälisches Institut für Wirtschaftsforschung, pages 09, 09.
    2. repec:zbw:rwipos:052 is not listed on IDEAS
    3. Jörg Peters & Jörg Langbein & Gareth Roberts, 2018. "Generalization in the Tropics – Development Policy, Randomized Controlled Trials, and External Validity," World Bank Research Observer, World Bank Group, vol. 33(1), pages 34-64.
    4. Alem, Yonas & Ruhinduka, Remidius D., 2020. "Saving Africa's tropical forests through energy transition: A randomized controlled trial in Tanzania," Ruhr Economic Papers 885, RWI - Leibniz-Institut für Wirtschaftsforschung, Ruhr-University Bochum, TU Dortmund University, University of Duisburg-Essen.
    5. Baulia, Susmita, 2019. "Take-up of joint and individual liability loans: An analysis with laboratory experiment," Journal of Behavioral and Experimental Economics (formerly The Journal of Socio-Economics), Elsevier, vol. 82(C).
    6. Florent Bédécarrats & Isabelle Guérin & François Roubaud, 2019. "All that Glitters is not Gold. The Political Economy of Randomized Evaluations in Development," Development and Change, International Institute of Social Studies, vol. 50(3), pages 735-762, May.
    7. Grimm, Michael & Peters, Jörg, 2012. "Improved cooking stoves that end up in smoke?," RWI Positionen 52, RWI - Leibniz-Institut für Wirtschaftsforschung.
    8. Stéphane J. Baele, 2013. "The ethics of New Development Economics: is the Experimental Approach to Development Economics morally wrong?," The Journal of Philosophical Economics, Bucharest Academy of Economic Studies, The Journal of Philosophical Economics, vol. 7(1), November.
    9. Whittington, Dale & Jeuland, Marc & Barker, Kate & Yuen, Yvonne, 2012. "Setting Priorities, Targeting Subsidies among Water, Sanitation, and Preventive Health Interventions in Developing Countries," World Development, Elsevier, vol. 40(8), pages 1546-1568.
    10. Pascaline Dupas & Edward Miguel, 2016. "Impacts and Determinants of Health Levels in Low-Income Countries," NBER Working Papers 22235, National Bureau of Economic Research, Inc.
    11. Ashish Arora & Michelle Gittelman & Sarah Kaplan & John Lynch & Will Mitchell & Nicolaj Siggelkow & Aaron K. Chatterji & Michael Findley & Nathan M. Jensen & Stephan Meier & Daniel Nielson, 2016. "Field experiments in strategy research," Strategic Management Journal, Wiley Blackwell, vol. 37(1), pages 116-132, January.
    12. Emily Breza & Cynthia Kinnan, 2018. "Measuring the Equilibrium Impacts of Credit: Evidence from the Indian Microfinance Crisis," Working Papers id:12587, eSocialSciences.
    13. Pedro Carneiro & Sokbae Lee & Daniel Wilhelm, 2020. "Optimal data collection for randomized control trials [Microcredit impacts: Evidence from a randomized microcredit program placement experiment by Compartamos Banco]," Econometrics Journal, Royal Economic Society, vol. 23(1), pages 1-31.
    14. Hoffmann, Bridget, 2018. "Do non-monetary prices target the poor? Evidence from a field experiment in India," Journal of Development Economics, Elsevier, vol. 133(C), pages 15-32.
    15. Okeke, Edward N. & Adepiti, Clement A. & Ajenifuja, Kayode O., 2013. "What is the price of prevention? New evidence from a field experiment," Journal of Health Economics, Elsevier, vol. 32(1), pages 207-218.
    16. Kabeer, Naila, 2020. "‘Misbehaving’ RCTs: The confounding problem of human agency," World Development, Elsevier, vol. 127(C).
    17. Augsburg, Britta & Rodríguez-Lesmes, Paul Andrés, 2018. "Sanitation and child health in India," World Development, Elsevier, vol. 107(C), pages 22-39.
    18. Michael Grimm & Anicet Munyehirwe & Jörg Peters & Maximiliane Sievert, 2015. "A First Step Up the Energy Ladder? Low Cost Solar Kits and Household’s Welfare in Rural Rwanda," Ruhr Economic Papers 0554, Rheinisch-Westfälisches Institut für Wirtschaftsforschung, Ruhr-Universität Bochum, Universität Dortmund, Universität Duisburg-Essen.
    19. Tilman Brück & Neil T. N. Ferguson, 2020. "Money can’t buy love but can it buy peace? Evidence from the EU Programme for Peace and Reconciliation (PEACE II)," Conflict Management and Peace Science, Peace Science Society (International), vol. 37(5), pages 536-558, September.
    20. Jacopo Bonan & Stefano Pareglio & Massimo Tavoni, 2014. "Access to Modern Energy: a Review of Impact Evaluations," Working Papers 2014.96, Fondazione Eni Enrico Mattei.
    21. Gunther Bensch & Jörg Peters, 2014. "The Intensive Margin of Technology Adoption - Experimental Evidence on Improved Cooking Stoves in Rural Senegal," Ruhr Economic Papers 0494, Rheinisch-Westfälisches Institut für Wirtschaftsforschung, Ruhr-Universität Bochum, Universität Dortmund, Universität Duisburg-Essen.

    More about this item

    Keywords

    Equipoise; Fairness; Ethics of RCTs; Control Group; Placebo;
    All these keywords.

    JEL classification:

    • C93 - Mathematical and Quantitative Methods - - Design of Experiments - - - Field Experiments
    • I14 - Health, Education, and Welfare - - Health - - - Health and Inequality
    • B41 - Schools of Economic Thought and Methodology - - Economic Methodology - - - Economic Methodology
    • O16 - Economic Development, Innovation, Technological Change, and Growth - - Economic Development - - - Financial Markets; Saving and Capital Investment; Corporate Finance and Governance
    • D63 - Microeconomics - - Welfare Economics - - - Equity, Justice, Inequality, and Other Normative Criteria and Measurement

    NEP fields

    This paper has been announced in the following NEP Reports:

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:sol:wpaper:2013/292092. See general information about how to correct material in RePEc.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: . General contact details of provider: https://edirc.repec.org/data/cebulbe.html .

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Benoit Pauwels (email available below). General contact details of provider: https://edirc.repec.org/data/cebulbe.html .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service hosted by the Research Division of the Federal Reserve Bank of St. Louis . RePEc uses bibliographic data supplied by the respective publishers.