At 03:39 PM 3/14/01 +0000, Jerry Dallal wrote:
>It wasn't ironically and has nothing to do with 5%. As Marvin Zelen
>has pointed out, one-tailed tests are unethical from a human
>subjects perspective because they state that the difference can go
>in only one direction (we can argue about tests that are similar on
>the boundary, but I'm talking about how they are used in practice).
>If the investigator is *certain* that the result can go in only one
>direction, then s/he is ethically bound not to give a subject a
>treatment that is inferior to another.
>
>Consider yourself or someone near and dear with a fatal condition.
>You go to a doc who says, "I can give you A with P(cure) in your
>case of 20% or I can give you B for which P(cure) can't be less than
>20% and might be higher. In fact, I wouldn't even consider B if
>there weren't strong reasons to suspect it might be higher. And
>let's not forget it can't be lower than 20%. I just flipped a
>coin. YOU CAN'T HAVE "B"!"
what can i say ... marvin zelen is wrong ...
it would only be unethical if a better alternative were available ... or
even a possibly better alternative were available ... and the investigator
or the one making the decision to give or not to give ... KNOWS this ...
AND HAS the ability to give this treatment to the patient ... and does NOT
do it
because a treatment might be known to be better, through a logical
deductive process or experimentation ... or potentially better ... does NOT
lead to unethical practice if this treatment is not adopted ...
implementations of treatments have consequences ... other than impact of
treatments ... there are COSTS ASSOCIATED WITH TREATMENTS and these costs
have to be weighed in from a cost/benefit perspective (maybe even take into
account IF the public WANTS this to be done) ... it is irresponsible NOT to
take other things into consideration
if the costs associated with treatments are so high compared to the (albeit
true) benefits ... one has to consider whether it would actually be
UNethical to go ahead and order up full implementation ... when society has
to shell out the $$$$
one vivid example: we KNOW for a fact that ... if we reduced the national
speed limit to 45 ... it would save thousands of lives ... though drivers
would be hopping mad (and road rage might cause some accidents ... the
reduction still would save many many lives) ...
are politicians, who make these decisions, acting in an unethical way NOT
to lower the national speed limit to 45? i don't think so
decisions to implement or not implement (regardless of evidence) in most
cases are some compromise between what we know MIGHT happen if we go
direction A ... but, we make a tempered decision to go in direction B ...
because of the realities of the overall situation
hypothesis testing ... is NO different
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_________________________________________________________
dennis roberts, educational psychology, penn state university
208 cedar, AC 8148632401, mailto:[EMAIL PROTECTED]
http://roberts.ed.psu.edu/users/droberts/drober~1.htm
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