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> 2. While we like to claim that a study randomizing people to alcohol wouldn't be ethical, pre-2014 I don't think that would have been true. I think there was
by quotemstr 8y ago
> 2. While we like to claim that a study randomizing people to alcohol wouldn't be ethical, pre-2014 I don't think that would have been true. I think there was enough equipoise. Post-2014, I would need to see some strong counter-evidence to make me think there is equipoise once again.
That's a very convenient way to socially forbid replication attempts. I don't buy it. The argument basically amounts to a claim that we answered the question definitively in 2014 and anyone questioning that result now is unethical. Today's scientific research, especially in any area pertaining to people, is too unreliable to blindly trust this way.
- joshgel 8y agoWhat's the line? If we found that some intervention group had 90% mortality with the control group having 10% mortality in some experiment, I think you would agree we shouldn't repeat that experiment with a lot of people as you would be randomizing to something likely to kill them. What about 20% mortality to 10%? What about 11% to 10%? What degree of certainty about the results do you need? Obviously there is a line somewhere. But, its not easy, so I wouldn't recommend dismissing such concerns glibly. Is that the same as claiming we answered the question definitively, or is that just ethical research?
- quotemstr 8y agoWe're not talking about administering arsenic to people just in case we're wrong about thousands of years of experience. We're talking about randomizing exposure to an activity that billions of people choose voluntarily, an activity that at worst has an effect of a few parts per 100,000. That's on the same order of risk as being struck by lightning. Unnecessary x-rays are likely worse. Why the outrage over this risk in particular? Declaring this level of risk to be outside the bounds of permissible research is an attitude incompatible with scientific progress. It's elevating short-term harm prevention to an unjustifiable extreme that makes it impossible to determine whether we have an accurate model of the world.
- carbocation 8y agoSure, you could run an alcohol intervention by an IRB and see what they say. If they think there is equipoise they might go for it. Just because I don't agree doesn't mean I feel strongly about it or would throw down some gauntlet.
- quotemstr 8y agoI don't accept the legitimacy of IRB rulings; I hope to see a day when these bodies stop blocking research. Researchers are competent to be ethical on their own. My reading (not just [1], although [1] is a lucid examination) suggests to me that IRBs are net detrimental to research. There's an incentive misalignment that pushes them too far in the "harm" prevention camp and that makes it too difficult to answer scientific questions. [1] http://slatestarcodex.com/2017/08/29/my-irb-nightmare/ http://slatestarcodex.com/2017/08/29/my-irb-nightmare/
- carbocation 8y ago> I don't accept the legitimacy of IRB rulings That's too bad. The rest of us try to learn something from Nuremberg.
- tptacek 8y agoIf I am following your logic here, you're saying that because you read a blog post in which a practitioner was surprised at how much more ethically complex it is to conduct scientific research than it is to simply deliver the current state of the art to a patient, you've come to believe that biomedical research should be freed from institutional oversight?
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- quotemstr 8y agoYes, I think IRBs today do more harm than good. Is that yet another opinion I'm not allowed to express in polite company?