• Matjaž Zwitter


To relieve human suffering—the motto of our profession—extends beyond our current patients to those in the future. The progress of medicine depends on medical research. Our discussion will be limited to clinical trials with critical ethical issues due to the active involvement of patients. From the patients’ standpoint, the essential demands are: a scientifically sound research plan; free choice to enter a trial or receive routine treatment; understandable informed consent; and, in the case of randomized trials, physician’s equipoise (sincere uncertainty) regarding preferences to the proposed treatments. Despite all efforts, some ethical costs are inevitable: in comparison to routine treatment, clinical research often includes additional diagnostics, the collection of personal data, and limited freedom to individualize treatment. Publication of results serves to counterbalance these inevitable ethical costs by offering useful information to benefit future generations of patients. While the commercial interests of sponsors are understandable and inevitable, investigators and physicians should avoid any bias in planning a clinical trial, in its conduct, and in final analysis and publication.


Clinical trials Informed consent Randomized clinical trials Equipoise Biased planning and analysis Publication bias 


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Matjaž Zwitter
    • 1
    • 2
  1. 1.Faculty of MedicineUniversity of MariborMariborSlovenia
  2. 2.Institute of OncologyLjubljanaSlovenia

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