> It's also a major ethics no-no to withhold known life-saving treatment in the name of continuing a trial.
The problem with this, of course, is that under certain circumstances terminating trials early for ethical reasons causes them to conclude that the treatment works when it doesn't.
Actually, pretty much all the apparently well thought-out ethical restrictions can lead to disaster, and there's even a set of studies that manages to accidentally demonstrate all of them - the randomized controlled trials into circumcision as a form of HIV prevention in Africa. In addition to rather unwisely terminating the study early, they were also careful to use sterile surgical instruments, made sure to inform the participants that they'd still need to use condoms and give them a supply of condoms and education on how to use them, and ensured that the newly-circumcised individuals refrained from sex whilst their wounds healed. All perfectly reasonable ethical requirements, and not ones we'd want to do away with.
Unfortunately, the actual interventions that have been made based on this study have none of those features. Men are being circumcised with bloody instruments, under the belief that this means they don't have to use condoms anymore, and any funding that's going towards circumcision is funding that's not being used to supply condoms and condom education. The difference between what's actually happening and what can ethically be studied is huge and most likely fatal. I suspect the whole thing's going to end up turning out to be another ill-conceived Western intervention that sows distrust a few years down the line.
The problem with this, of course, is that under certain circumstances terminating trials early for ethical reasons causes them to conclude that the treatment works when it doesn't.
Actually, pretty much all the apparently well thought-out ethical restrictions can lead to disaster, and there's even a set of studies that manages to accidentally demonstrate all of them - the randomized controlled trials into circumcision as a form of HIV prevention in Africa. In addition to rather unwisely terminating the study early, they were also careful to use sterile surgical instruments, made sure to inform the participants that they'd still need to use condoms and give them a supply of condoms and education on how to use them, and ensured that the newly-circumcised individuals refrained from sex whilst their wounds healed. All perfectly reasonable ethical requirements, and not ones we'd want to do away with.
Unfortunately, the actual interventions that have been made based on this study have none of those features. Men are being circumcised with bloody instruments, under the belief that this means they don't have to use condoms anymore, and any funding that's going towards circumcision is funding that's not being used to supply condoms and condom education. The difference between what's actually happening and what can ethically be studied is huge and most likely fatal. I suspect the whole thing's going to end up turning out to be another ill-conceived Western intervention that sows distrust a few years down the line.