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ABSTRACT

Ethics has been identified as a central reason for choosing a stepped wedge trial over other kinds of clinical trials. The stepped wedge design uses phased implementation, which means that all arms of the trial receive the active intervention over the course of the study. Some groups receive it later than others, but the intervention is not withheld from any group. This system of phased implementation has been identified as ethically advantageous in two instances: (1) when the intervention is thought to be especially likely to be effective and (2) in emergency situations, such as research conducted during emerging epidemics. But despite the increased use of the stepped wedge design and appeals to its ethical superiority as the motivation for its use, there has been little attention to the stepped wedge in the ethics literature.

In this talk I will consider whether there are persuasive reasons to prefer or to require a stepped wedge trial. I will argue that while the stepped wedge is ethically permissible, it is not morally superior to other kinds of trials. To this end, I will examine the ethical justification for providing, withholding, and delaying interventions in research.

Forthcoming events

Richard Doll Seminar: Design and analysis of prevalence surveys in low-resource settings

Tuesday, 25 February 2020, 1pm to 2pm @ Richard Doll Lecture Theatre, Richard Doll Building, Old Road Campus, OX3 7LF

WEH/Ethox Seminar: Negligence and abortion - doctors' duty of care challenges and potentials in light of Montgomery v Lanarkshire Health Board

Wednesday, 26 February 2020, 11am to 12.30pm @ Seminar room 0, Big Data Institute, Old Road Campus, OX3 7LF

HERC Seminar: Learning healthcare systems for cost-effective precision oncology.

Thursday, 27 February 2020, 12pm to 1pm @ Seminar room 0, Big Data Institute, Old Road Campus, OX3 7LF

The Global Response to the Novel Coronavirus (SARS-CoV-2) Outbreak

Thursday, 27 February 2020, 2.30pm to 4pm @ Seminar rooms, Big Data Institute

Richard Doll Seminar: The Risk of Everything – using linked electronic health records to develop and validate risk prediction tools for use in clinical care

Tuesday, 03 March 2020, 1pm to 2pm @ Richard Doll Lecture Theatre, Richard Doll Building, Old Road Campus, OX3 7LF

WEH/Ethox Seminar: Building research capacity through North-South Partnerships: some ethical reflections and a social justice agenda

Wednesday, 04 March 2020, 11am to 12.30pm @ Seminar room 0, Big Data Institute, Old Road Campus, OX3 7LF