A desperate solution: Individual autonomy and the double-blind controlled experiment

The randomization ingredient in double-blind controlled experiments may be objectionable to patients who, in their desperation , come to such trials seeking a last chance of cure. Minogue et al. , who view such a situation as inherently exploitive and undermining of patient autonomy, propose that such “ desperate volunteers ” instead be enrolled in the active arm , while other patients , less desperate and more committed to medical progress, continue to be randomized. Their view is critiqued as destructive of medical progress , inappropriate in its lack of clinical response to such patients , and fatally flawed by unrealistic notions of autonomy and voluntariness.