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When Argument Fails

One of the secrets to having a successful career is to write a controversial article early on. Ensuing responses generate a dialogue with interlocutors guaranteed to pad one’s curriculum vitae for years to come. My own work on the issue of placebo-controlled trials is critical of the excessive reliance on placebo controls in new drug trials, because such studies often violate clinical equipoise and suffer from scientiac shortcomings. While Miller and Brody’s (2002) critique does offer an opportunity to continue this dialogue, it is remarkable only in its ahistoricism, misconstrual of well-accepted concepts, and failure to grasp basic issues in the methodology of randomized controlled trials (RCTs). Miller and Brody’s central thesis is that the concept of clinical equipoise conoates the ethics of clinical practice with the ethics of clinical research.