Ethical stance on placebo in trials when standard life-saving treatment exists?

• A. It may be ethically dropped
• B. It must always be used
• C. It should be replaced with double-blind design
• D. It is irrelevant

Answer: (B)

When a proven life-saving treatment exists for a condition, giving a placebo to some trial participants would withhold effective therapy and risk serious harm. Ethically, you must provide the standard of care to all participants. The experimental intervention should be evaluated as an add-on to that standard care or compared against an active control, not against placebo. This preserves patient welfare while still allowing rigorous assessment of whether the new treatment adds benefit. Placebo controls are only acceptable when no proven therapy exists or when withholding treatment does not expose patients to harm beyond the condition itself, with appropriate safety measures and rescue options. In short, do not withhold life-saving therapy; use add-on designs or active comparators to test new treatments.