Ethics of the Randomized Clinical Trial

To the Editor: Except for randomization, Arthur Schafer examines problems not exclusively "posed by the randomized clinical trial" (Sept. 16 issue). Why, then, aim his essay at such trials? Indeed, if we agree that uncontrolled trials are scientifically (hence, ethically) inferior to those that are controlled and accept the ethical imperative to do our best, we must perform randomized clinical trials whenever feasible (with due regard to Schafer's "ethical dilemmas"). The author's comments on the "commitment to promote the acquisition of scientific knowledge" are propounded as if this commitment existed in a vacuum. Acquiring knowledge in a randomized clinical . . . No extract is available for articles shorter than 400 words.