Is the research necessary? Equipoise and other fundamental ethical considerations

Abstract

This paper examines issues concerning the necessity of research as an essential ethical question fundamental to ethical scrutiny of research proposals. In particular, the concept of 'equipoise' as a pre-condition to conducting a clinical trial is examined. Equipoise refers to the degree of uncertainty over what constitutes best practice: existing or experimental interventions or various approaches to care. It is applied to individual practitioners, the profession as a whole and communities of patients and their advocates. Nurses' positive response to current government views on the evidence basis of practice and decision-making within the new NHS gives prominence to research feeding into the clinical governance process. This paper contributes to the ethical debates over nursing research and takes account of the view that some research - clinical trials in particular - should not proceed in the absence of equipoise.