Early stopping of clinical trials: charting the ethical terrain

Kennedy Inst Ethics J. 2011 Mar;21(1):51-78. doi: 10.1353/ken.2011.0002.


The decision to terminate a clinical trial earlier than planned is often described as ethically problematic, but it is rarely systematically analyzed as an ethical issue in its own right. This paper provides an overview of the main ethical considerations at stake in such decisions and of the main tensions between these considerations. Arguments about informed consent and the impact of early stopping on research and society are explored. We devote particular attention to a familiar conflict that arises with special urgency when early data suggest that the experimental treatment is superior. Should the trial be stopped so that participants in the control group will not be allocated a seemingly inferior treatment, or should it continue in pursuit of evidence conclusive enough to improve the care of future patients? We scrutinize three ways to address this problem. Rather than dissolving the tension, they represent different trade-offs between the respective welfare interests of subjects and future patients.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Clinical Trials, Phase III as Topic / economics
  • Clinical Trials, Phase III as Topic / ethics*
  • Conflict, Psychological
  • Double-Blind Method
  • Ethics, Research
  • Evidence-Based Medicine* / standards
  • Evidence-Based Medicine* / trends
  • Humans
  • Informed Consent* / ethics
  • Randomized Controlled Trials as Topic / economics
  • Randomized Controlled Trials as Topic / ethics*
  • Research Subjects*
  • Safety
  • Therapeutic Equipoise*
  • Therapeutic Misconception
  • Time Factors
  • Treatment Outcome