We know from Rabkin et al’s paper How blind is blind? Assessment of patient and doctor medication guesses in a placebo-controlled trial of imipramine and phenelzine. that particpants in drug trials often know whether or not they get the active drug.
Standard protocols for double-blinding don’t effectively prevent the participants from knowing whether they get a placebo or the real drug. Yet there little interst of people running studies to ask the participants of their trials whether they know what they are getting.
OK, but how does that lead to “the focus on objectivity is not without problems”?
Badly run trials are evidence for the proposition that some trials are badly run, not for the proposition that focusing on objective results is problematic.
It’s not about badly run trials in the sense that trials are not run according to the gold standard. The issue is that taking active pills frequently feels different than taking sugar pills even when both pills look the same way. That’s information that patients can use to know whether they are on the active drug.
In a world where people would sincerely care about whether trials actually prevent the participants from knowing the questions that Rabkin’s asks would be routine questions in every trial.
Asking patients whether they think they got the drug or placebo, is querying for subjective knowledge. That’s a “way of knowing” that yields knowledge but that’s not practiced. A “way of knowing” that the paper you linked would predict to be neglected.
We know from Rabkin et al’s paper
How blind is blind? Assessment of patient and doctor medication guesses in a placebo-controlled trial of imipramine and phenelzine.
that particpants in drug trials often know whether or not they get the active drug.Standard protocols for double-blinding don’t effectively prevent the participants from knowing whether they get a placebo or the real drug. Yet there little interst of people running studies to ask the participants of their trials whether they know what they are getting.
OK, but how does that lead to “the focus on objectivity is not without problems”?
Badly run trials are evidence for the proposition that some trials are badly run, not for the proposition that focusing on objective results is problematic.
It’s not about badly run trials in the sense that trials are not run according to the gold standard. The issue is that taking active pills frequently feels different than taking sugar pills even when both pills look the same way. That’s information that patients can use to know whether they are on the active drug.
In a world where people would sincerely care about whether trials actually prevent the participants from knowing the questions that Rabkin’s asks would be routine questions in every trial.
Asking patients whether they think they got the drug or placebo, is querying for subjective knowledge. That’s a “way of knowing” that yields knowledge but that’s not practiced. A “way of knowing” that the paper you linked would predict to be neglected.