To the Editor: Both Dr Woodward's1
article and Dr Ellis' Editorial are based on the premise that patients are
at risk of having their protection "eroded" when they sacrifice themselves
by participating in randomized clinical trials. The former author decries
"new pressures to subordinate the interests of the subject to those of science
and society," and the latter quotes from Katz et al, "When may a society .
. . expose some of its members to harm in order to seek benefits for them,
for others, or for society as a whole?" Even JAMA assumes that patients
may be harmed in randomized clinical trials by offering continuing medical
education credit for those who read Woodward's piece based on the educational
objective: "To understand how medical research may threaten human subject
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