Equipoise in Research - Essay Sample

Introduction

Equipoise is a state of balance. Equipoise is commonly used in the medical field where the other name of equipoise is clinical equipoise. Therefore equipoise is the design of the clinical trials, and it refers to a state where the benefits and risks of an alternative treatment offered during a clinical trial are balanced (McCleary, 2016). The reason is that there is no pre-existing advantage should be known to exist for one treatment over the other thus an ethical consideration of the research in the clinical field.

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The problem with equipoise is in the widespread agreement that ethics needs that each clinical trial starts with a reasonable null hypothesis. Thus equipoise is an ethical condition which is necessary in almost all cases of clinical research. It is of importance that the researcher is in a state of genuine uncertainty regarding the two different merits of treatment, for instance, A and B of the population. If the two treatments are not equivalent, the superior treatment will be needed according to ethics.

Researchers Must Respect Autonomy and Not Be In Equipoise

There are different ethics which guides the research work; one example of ethics in research is the autonomy. Autonomy, therefore, refers to the right of any individual to choose the kind of activity they will participate in or not. Full freedom requires that a person should be able to understand what is necessary for them to do and then make a reasonable judgment concerning the effect the participants will have on them and decide to participate from coercive influence freely (London, 2017).

Equipoise in research should be evident in that the researcher should be uncertain on the difference between the two trials to have a level of balance. In most cases, equipoise is abused or disturbed by the researchers because narrowing the extreme conditions and hypotheses of research to ensure a valid of the results may be strong making the researchers believe that no open-minded results to be considered in favor of the other (London, 2017).

With the rapid increase of concern about the ethics of research and also curricular of graduate schools increase, the issue of equipoise is likely to become more common .thus the requirement of equipoise impacts a practical threat to the clinical researcher.

Therefore being that both equipoise and autonomy are both ethical practices in research, researchers are not required to be in equipoise, but they must then respect independence. The impact is that the researchers will not be restricted to operate to a certain level but will have the choice on what to do and what to ignore.

Clinical Equipoise

Researchers are required to be in a state of clinical equipoise and again respect autonomy. Clinical equipoise is a state of uncertainty concerning the merits relative of two or more treatments that are tested which are characterized by honesty. Clinical equipoise opposes the fact that the evidence regarding the two procedures is precisely balanced, nor does it require that uncertainty about the preferred treatment by the individual's practitioners (McCleary, 2016).

A clinical equipoise has been very popular among the researchers. An assumption is that clinical equipoise is an ethical practice which helps in addressing the psychological needs of the researcher. For examples, some researchers never went to a research school, like physician researcher after all went to a medical school. Thus for them to think of the research with patients outside the ethical model of the patient-physician relationship as required may be threatening and confusing to them. As a result, clinical equipoise offers the basic formula that seems to both the roles of a physician for example and those of the researcher so that they embrace a psychological comfort.

The theory of clinical equipoise states that where there is no support for treatment regimen in the area of the expert clinical community, then the first ethical requirement of clinical equipoise is lacking. Therefore the research is obliged to conduct the investigation unethically. The theory of clinical research also adds more strength that the most important results of the study might be to relieve the crisis of confidence in the ethics of clinical research (McCleary, 2016).

A situation of clinical equipoise is consistent on the part of the researchers with a decided treatment preference. The researchers must first identify that the less favored treatment is most preferable with the colleagues whom they regard to be competent and responsible. When the interim results favor the researcher's preferences that is treatment B, the clinical equipoise persists provided that those results are too weak to influence the community clinicians' judgment. It may be due to the limited size of the sample, possibilities of side effect are unresolved and any other factor. Therefore the judgment, in this case, can only be made by experts in the interim results which can be a data monitoring committee or the researchers.

There is a recurrent debate about the ethical priority in conducting clinical trials. Given nature and also the purpose of doing clinical research, the researcher is dedicated to primarily promote the medical good of future patients using scientific knowledge derived from the research experimentations. Therefore as the researcher's respect autonomy, they should also be in a state of clinical equipoise for their benefit.

Theoretical Equipoise

Researchers are required to be in a state of theoretical equipoise and respect autonomy as well. Theoretical equipoise is existing when the overall evidence of the trial between two or more treatments is precisely balanced. Theoretical equipoise is very fragile because it is easily disturbed by a very small accretion of evidence favoring one side of the trial. Apart from being fragile, theoretical equipoise is highly sensitive to the vagaries of the researcher's perception and attention (McCleary, 2016).

According to theoretical view, equipoise is mostly disturbed when the results indicate that A will be more successful than B are anything but not 50 percent, thus making it necessary to randomize treatment assignment beginning with the first patient who unless equipoise is disturbed. Theoretical equipoise is finally appropriate to a one-dimensional hypothesis thus causing researchers to think in those terms. It emphasizes that the null hypothesis must be very simple to be finely balanced. For example, will A or B become superior in the reduction of the shrinking or tumors fever in population P?

Theoretical equipoise is complicated in a way that the research problems should be evident. Thus requires a researcher to understand the alternative, recall the fundamental reasons for conducting research and interpret the equipoise preferably. Finally, theoretical equipoise is so personal and also idiosyncratic, and this makes it easy for a researcher to violate the requirements of the equipoise. Because of the nature of the theoretical equipoise being disturbed as soon as the researchers perceive a difference between the alternatives, it will require at some point the researcher to show visually different survivals to raise ethical difficulties for the participants.

As far as the theoretical equipoise is concerned, it is of importance that researchers be in a state of theoretical equipoise and also respect autonomy. It helps in minimizing the chances of making errors and thus coming up with more accurate and precise results. And also in choosing the variables A and B, theoretical equipoise ensures that the researcher choses them depending on the combinations of effectiveness, consistency, relievable or minimal side effects plus other variable factors.

The Contrasts Between Theoretical and Clinical Equipoise

The clinical equipoise is robust in comparison to the theoretical equipoise because the difficulties of ethics are greatly alleviated at the start and the end of the trial. Theoretical equipoise emphasizes on the lack of the evidence which is favoring one arm over another required, on the other hand, clinical equipoise places more emphasis on informing patients on the honest disagreement among the clinician's experts. Lastly, clinical equipoise does not depend on conveying important information from the subjects and researchers as opposed to theoretical equipoise but rather allow the researchers to distinguish among the validated knowledge accepted by the clinical community appropriately.

Conclusion

Considering the debates between the clinical equipoise and the theoretical equipoise, I support that researchers should be in a state of clinical equipoise. The reason is that clinical equipoise is robust; it emphasizes informing the patients of the honest disagreement among the clinicians who are experts. Also, clinical equipoise does not depend so much on concealing the information which is relevant from subjects or researchers but instead allows researchers to distinguish among validated knowledge appropriately accepted by the clinical community, those data on treatments which are promising but are not convincing. Therefore, clinical equipoise serves well as a stable formulation of the approach of many individuals towards research ethics (McCleary, 2016).

References

London, A. J. (2017). Equipoise in research: integrating ethics and science in human research. Jama, 317(5), 525-526.

McCleary, L. (2016). Equipoise in clinical nursing research. Canadian Journal of Nursing Research Archive, 34(3).