All of the authors this week have attempted to dispel the notion that RCTs as a regulatory tool are universally affective for ensuring the safety of publically available drugs. They are meant to remove all subjective bias, the supposed enemy of honest scientific development, in favour of an objective standard of evaluation. However, as McGoey argues: “the majority of RCTs are conducted by entities with commercial stake in the outcome.” (McGoey, 73.) Bias seems impossible to ultimately remove from a field so laden with commercial and political interests.
What seems interesting to me is how the illusion of impartially in RCTs makes them less vulnerable to serious critique (at least enough to see them removed from certain regulatory practices.) There are going to be incomplete arguments of the efficacy and safety of drugs on all sides but the illusion of an objective moderator keeps the pharmaceutical world spinning around in a politically justifiable manner. Regulations are supposed to ensure some quality control on the drugs they license but they seem unable to do that in this scenario.
When reasons run out and arguments remain incomplete, as they always seem to be in medical discourse, the political (and implicitly the moral) realm takes over. Interestingly, this means that drugs are moral (or politically viable) to prescribe and sell only because they passed certain regulations which do not necessarily ensure their safety which was the moral concern in the first place. What then does a good regulation look like?