I cannot believe that a clinical trial of a new drug in a field in which there are accepted beneficial therapies would be either proposed as ethical by physicians or accepted by the Food and Drug Administration when containing a control group deprived of that beneficial treatment. For prior approval of the existing beneficial treatment, there must have been a comparison with prior therapies, leading ultimately to controlled comparisons with placebos or no treatment. To redo those comparative analyses is to reinvent the wheel–at the great expense of those volunteers who were deprived of the current best treatment and at the expense of the investigation. This is at once bad science, abysmal ethics, and wasteful economics.

McClellan G. Blair
Indiana, Pa.

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