Control Groups on Trial: The Ethics of Testing Experimental Ebola Treatments

Abstract Although randomized controlled trials (RCTs) are generally considered the “gold standard” for testing experimental treatments, their use for Ebola has been subject to strong criticism by prominent ethicists and international aid organizations, and only one of the ongoing Ebola treatment trials has been designed in this manner. This is not the first time that RCTs in developing countries have provoked ethical controversy, but the objections to the Ebola clinical trials are fundamentally different from the concerns that have been raised in the past. After briefing reviewing the ongoing research on experimental Ebola treatments, this Article examines the current controversies in the context of previous debates over the ethics of international clinical research. It concludes that RCTs provide the most reliable method for developing effective Ebola treatments, and that their methodological rigor is itself a persuasive ethical argument in favor of using them. However, limited departures from the methodologically ideal approach may be necessary to accommodate the expectations of participants and to promote community trust.