Reductio ad absurdum in critical care trials

In the specific field of randomized controlled trials, it may be speculated whether reductio ad absurdum is an appropriate rejoinder to the similarly problematic petitio principii (“begging the question” [14]) that has been used to inappropriately sustain the need for randomized controlled trials (“Randomized controlled trials are the gold standard to assess the effect of an intervention, therefore we need randomized trials for all actions we do”). Defining targets for tidal volume, blood pressure, volemia, etc., for a critically ill patient whose condition continuously change is impossible if these terms are not properly defined, but once they are there is no reason to not test whether our target results in better outcomes or not. [...]much of the disappointment with randomized controlled trials are rotted in bad methods, poor interpretation of the results, fear and perhaps imprudent addition of trials results in iron-fisted guidelines.