Once a certain threshold of evidence is passed, there is no longer genuine uncertainty about the most beneficial treatment, so there is an ethical imperative for the investigator to provide the superior intervention to all participants.
For instance, the Canadian Tri-Council Policy Statement[3] endorses it, whereas the International Conference on Harmonisation of Technical Requirements for Registration of Pharmaceuticals for Human Use (ICH) does not.
[citation needed] In contrast, a series of studies of national cancer institute funded trials suggests an outcome pattern consistent with clinical equipoise.
Clinical equipoise occurs "if there is genuine uncertainty within the expert medical community — not necessarily on the part of the individual investigator — about the preferred treatment.
They state, "The doctrine of clinical equipoise is intended to act as a bridge between therapy and research, allegedly making it possible to conduct RCTs without sacrificing the therapeutic obligation of physicians to provide treatment according to a scientifically validated standard of care.
This constitutes therapeutic misconception concerning the ethics of clinical trials, analogous to the tendency of patient volunteers to confuse treatment in the context of RCTs with routine medical care.