Linsey McGoey discusses on the ineffectiveness of the antidepressants due to the methodological flaws in randomized controlled trials. One of the reasons why RCTs are exalted is because they in some way can provide a blind for the trialists so that there would be less otherwise inevitable, unrestrained personal bias. The reason why the drugs which show statistical significance do not have clinical effectiveness is that the subjects of the drug trials and the targeted patients are not the same people. Because of the heavy ethical constraints on not taking severely ill patients as subjects of human trial phase of a drug in order to protect them from harm and exploitation, trialists do not have the right subjects. What is more, because the research and trials are commercially motivated by the funding or the conducting by the pharmaceutical company, trialists take who show no sign of placebo in order to show the statistical significance. Therefore, we can see that the method itself removes the bias within the trial between controlled and experimented groups, but it is not guaranteed that RCT can provide absolute bias-proof when trialists are finding dog holes to manipulate data even before the trials can initiate. I do not think there should be such strict ethical constraints on using severely ill patients as subjects for a new drug if they and their families consent ━ although the concern is that they might not be able to make an informed and accountable consent, because the drug is targeting those kinds of patients. If the drug is prescribed for those severely ill patients, it does not make sense to test it on no other than those patients. We cannot expect anything less than picking only certain subjects by the drug companies in order to show that there is no placebo, since they would want to maximize the difference between controlled and experimented group and to prove the benefits of that new drug. The experiments are especially not easy with psychiatry since the qualitative emotions cannot be fully translated into quantitative measures of intensity.
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