Alderson P
Institute of Education, University of London.
J Med Ethics. 1996 Jun;22(3):135-9. doi: 10.1136/jme.22.3.135.
Equipoise is advocated as a means of achieving high scientific and ethical standards in randomised trials. As used in the context of research the word describes a state of uncertainty characterised by the belief that in a trial no arm is known to offer greater harm or benefit than any other arm. Clinicians who lack personal equipoise are advised to accept clinical or communal equipoise, based on current unresolved disagreement among the medical profession. Equipoise is mainly discussed in the literature as an issue for senior doctors and research directors. Limitations of professional equipoise are reviewed, and data on the neglected topic of patients' equipoise are reported using the example of breast cancer trials. In theory, a patient who gives informed and voluntary consent to enter a randomised trial has achieved the equilibrium of equipoise. In practice, equipoise among patients ranges from personal to proxy acceptance.
均衡被倡导为在随机试验中实现高科学和伦理标准的一种手段。在研究背景下使用时，这个词描述的是一种不确定状态，其特征是相信在试验中，没有任何一组已知比其他组带来更大的危害或益处。建议缺乏个人均衡的临床医生基于医学专业目前未解决的分歧接受临床或群体均衡。均衡在文献中主要作为资深医生和研究主任的一个问题来讨论。回顾了专业均衡的局限性，并以乳腺癌试验为例报告了关于被忽视的患者均衡主题的数据。理论上，给予知情且自愿同意参加随机试验的患者已实现了均衡的平衡。在实践中，患者之间的均衡范围从个人接受至代理接受。
