This is something I’ve heard a few times now. I emailed a health writer, Bill Sardi, regarding a piece he’d written on a miracle anti-cancer drug. His piece referred to a trial published in 2008 in the International Journal of Cancer that had a total of 16 women all given the drug for 4 years. As JCmacc pointed out on the Bad Science forums: There was no control group. All 4 women had a breast tumour removed surgically and were given chemotherapy or radiotherapy to kill off any metastatic cells prior to the trial in question starting. The fact none of these women relapsed during the 4 years isn’t a shock given their conventional therapy. I dropped Bill an email and put some of these points to him (that there was no control group, that the women has conventional treatment…) and Bill responded with an email that included this:
DO YOU THINK YOU CAN ETHICALLY HAVE A CONTROL GROUP WHEN CANCER PATIENTS ARE DYING?
Now, I’ve been thinking this through and I’m not sure how it can be unethical to have a control group for a treatment that may or may not work. It is true that some trials have been stopped early on ethical grounds when it became clear that substance x worked and it would have been unethical to deny the control group this remedy (or when it became clear that substance y was linked to an increased risk of death, as I believe was the case with Beta Carotene in smokers*). However, I think it is generally the case that if you don’t know whether a treatment works then you can’t know whether it is unethical to withold it – and the point of conducting a trial is to find out precisely that. However emotively it is framed, the idea that it is unethical to withold unproven treatments from a group in a trial is a wrong-headed one in my book.
You can Google “BIll Sardi” for more health advice – on resveratrol, on statins not saving lives, on dissolving gallstones naturally and, of course, on antioxidants.
*Beta Carotene and smokers – NCI summary of trial.
Durham CC thought it unethical not to give unproven fish oil pills to children: The Fishy Reckoning.
And finally: someone has done a meta analysis looking at “Placebo-Controls in Short-Term Clinical Trials of Hypertension” Al-Khatib. Also – The Ethical Use of Placebo in Clinical Trials Involving Children (Derivan et al).