The Therapeutic Orientation to Clinical Trials

Traditionally, clinical trials have been understood as continuous with clinical medicine. 1 In providing medical care for patients, the physician makes observations, investigates, tests hypotheses, and experiments with different treatments. Moreover, the exemplary physician is always learning how to improve treatment for future patients on the basis of clinical experience with current patients and familiarity with the medical literature. Chalmers summarized this view as follows: “The practice of medicine is in effect the conduct of clinical research . . . . Every practicing physician conducts clinical trials daily as he is seeing patients. The research discipline known as the `clinical trial' . . .