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Volumn 27, Issue 4, 2013, Pages 175-185

The ethics of sham surgery in parkinson's disease: Back to the future?

Author keywords

Neurosurgery; Parkinson's Disease; Placebo; Research ethics; Sham surgery

Indexed keywords

ARTICLE; CLINICAL TRIAL (TOPIC); CONTROL GROUP; ETHICS; HUMAN; MEDICAL ETHICS; METHODOLOGY; PARKINSON DISEASE; PROFESSIONAL STANDARD;

EID: 84876850294     PISSN: 02699702     EISSN: 14678519     Source Type: Journal    
DOI: 10.1111/j.1467-8519.2011.01931.x     Document Type: Article
Times cited : (12)

References (122)
  • 1
    • 0033598429 scopus 로고    scopus 로고
    • Use of Placebo Surgery in Controlled Trials of a Cellular-Based Therapy for Parkinson's disease
    • T.B. Freeman et al. Use of Placebo Surgery in Controlled Trials of a Cellular-Based Therapy for Parkinson's disease. N Engl J Med 1999; 341: 988-991.
    • (1999) N Engl J Med , vol.341 , pp. 988-991
    • Freeman, T.B.1
  • 2
    • 84876833565 scopus 로고    scopus 로고
    • Stereotactic surgery involves using images from CT or MRI scans to map the brain and provide location co-ordinates which are translated to a stereotactic frame fitted to the patient's head. This is used to guide an electrode (or cannula in the case of neurotransplantation) to the area of the brain to be treated. The stereotactic frame is affixed to the skull with metal pins and the electrode or cannula is inserted into the brain via a burr hole drilled through the skull. Such procedures may be performed under general or local anaesthesia. See R.A.E. Bakay, ed. Movement Disorder Surgery: The Essentials. New York, NY: Thieme Medical Publishers, Inc.
    • Stereotactic surgery involves using images from CT or MRI scans to map the brain and provide location co-ordinates which are translated to a stereotactic frame fitted to the patient's head. This is used to guide an electrode (or cannula in the case of neurotransplantation) to the area of the brain to be treated. The stereotactic frame is affixed to the skull with metal pins and the electrode or cannula is inserted into the brain via a burr hole drilled through the skull. Such procedures may be performed under general or local anaesthesia. See R.A.E. Bakay, ed. Movement Disorder Surgery: The Essentials. New York, NY: Thieme Medical Publishers, Inc.
  • 3
    • 84876857025 scopus 로고    scopus 로고
    • American Medical Association. Code of Medical Ethics. Available at:
    • American Medical Association. Code of Medical Ethics. Available at: http://www.ama-assn.org/ama/pub/physician-resources/medical-ethics/code-medical-ethics.shtml
  • 4
    • 84876838771 scopus 로고    scopus 로고
    • American Association of Neurological Surgeons and Congress of Neurological Surgeons. Position Statement on Placebo Surgery. Available at:
    • American Association of Neurological Surgeons and Congress of Neurological Surgeons. Position Statement on Placebo Surgery. Available at: http://www.aans.org/Media/Article.aspx?ArticleId=97932000
    • (2000)
  • 5
    • 76249113603 scopus 로고    scopus 로고
    • Effectiveness and Cost-effectiveness of Arthroscopic Lavage in the Treatment of Osteoarthritis of the Knee: a Mixed Methods Study of the Feasibility of Conducting a Surgical Placebo-controlled Trial (the KORAL study)
    • M.K. Campbell et al. Effectiveness and Cost-effectiveness of Arthroscopic Lavage in the Treatment of Osteoarthritis of the Knee: a Mixed Methods Study of the Feasibility of Conducting a Surgical Placebo-controlled Trial (the KORAL study) Health Technol Assess 2010; 14(5).
    • (2010) Health Technol Assess , vol.14 , Issue.5
    • Campbell, M.K.1
  • 6
    • 84876833095 scopus 로고
    • For example World Medical Association General Assembly. Declaration of Helsinki: Ethical Principles for Medical Research Involving Human Subjects.
    • For example World Medical Association General Assembly. Declaration of Helsinki: Ethical Principles for Medical Research Involving Human Subjects. http://www.wma.net/en/30publications/10policies/b3/17c.pdf1964
    • (1964)
  • 7
    • 84876884074 scopus 로고    scopus 로고
    • National Bioethics Advisory Commission. 2001. Ethical and Policy Issues in Research Involving Human Participants (Summary). Bethesda, MA; General Medical Council. 2002, Good Practice in Research; Medical Research Council. 2000. Good Research Practice. London: Medical Research Council; Royal College of Physicians. Guidelines on the Practice of Ethics Committees in Medical Research. Available at:
    • National Bioethics Advisory Commission. 2001. Ethical and Policy Issues in Research Involving Human Participants (Summary). Bethesda, MA; General Medical Council. 2002, Good Practice in Research; Medical Research Council. 2000. Good Research Practice. London: Medical Research Council; Royal College of Physicians. Guidelines on the Practice of Ethics Committees in Medical Research. Available at: http://bookshop.rcplondon.ac.uk/contents/pub232-e0da0967-8bed-4ac3-a12f-b05ad6a6c873.pdf2007
    • (2007)
  • 8
    • 84876854344 scopus 로고    scopus 로고
    • Council of Europe. 1997. Convention on Human Rights and Biomedicine. Available at:
    • Council of Europe. 1997. Convention on Human Rights and Biomedicine. Available at: http://conventions.coe.int/Treaty/Commun/QueVoulezVous.asp?NT=164&CL=ENG
  • 9
    • 84876835008 scopus 로고    scopus 로고
    • Council of Europe. Additional Protocol to the Convention on Human Rights and Biomedicine, Concerning Biomedical Research. Available at
    • Council of Europe. Additional Protocol to the Convention on Human Rights and Biomedicine, Concerning Biomedical Research. Available at http://conventions.coe.int/treaty/en/treaties/html/195.htm2005
    • (2005)
  • 10
    • 0003557021 scopus 로고    scopus 로고
    • The Ethics of Medical Research on Humans
    • Cambridge: Cambridge University Press.
    • C. Foster. 2001. The Ethics of Medical Research on Humans. Cambridge: Cambridge University Press.
    • (2001)
    • Foster, C.1
  • 11
    • 84876838513 scopus 로고    scopus 로고
    • Note there has also been a parallel debate regarding sham knee arthroscopy and other orthopaedic surgery
    • Note there has also been a parallel debate regarding sham knee arthroscopy and other orthopaedic surgery
  • 12
    • 0030053119 scopus 로고    scopus 로고
    • Arthroscopic Treatment of Osteoarthritis of the Knee
    • J.B. Moseley et al. Arthroscopic Treatment of Osteoarthritis of the Knee. Am J Sports Med 1996; 24: 28-34
    • (1996) Am J Sports Med , vol.24 , pp. 28-34
    • Moseley, J.B.1
  • 13
    • 0037063133 scopus 로고    scopus 로고
    • A Controlled Trial of Arthroscopic Surgery for Osteoarthritis of the Knee
    • J.B. Moseley et al. A Controlled Trial of Arthroscopic Surgery for Osteoarthritis of the Knee. N Engl J Med 347; 2002: 31-88
    • (2002) N Engl J Med , vol.347 , pp. 31-88
    • Moseley, J.B.1
  • 14
    • 34247162826 scopus 로고    scopus 로고
    • Sham Surgery in Clinical Trials
    • P. Angelos. Sham Surgery in Clinical Trials. JAMA 2007; 297: 1545-1546
    • (2007) JAMA , vol.297 , pp. 1545-1546
    • Angelos, P.1
  • 15
    • 34247162826 scopus 로고    scopus 로고
    • Sham Surgery in Clinical Trials-Reply
    • D.R. Flum. Sham Surgery in Clinical Trials-Reply. JAMA 2007; 297: 1545-1546
    • (2007) JAMA , vol.297 , pp. 1545-1546
    • Flum, D.R.1
  • 16
    • 34447290650 scopus 로고    scopus 로고
    • The Ethics of Sham Surgery in Clinical Orthopaedic Research
    • S. Mehta et al. The Ethics of Sham Surgery in Clinical Orthopaedic Research. J Bone Joint Surg 2007; 89: 1650-1653
    • (2007) J Bone Joint Surg , vol.89 , pp. 1650-1653
    • Mehta, S.1
  • 17
    • 34548424011 scopus 로고    scopus 로고
    • The Applicability of Clinical Equipoise and Sham Surgery in Patients with Symptomatic Lumbar Radiculopathy due to a Herniated Disc
    • A.R. Vaccaro & M.G. Fehlings. The Applicability of Clinical Equipoise and Sham Surgery in Patients with Symptomatic Lumbar Radiculopathy due to a Herniated Disc. Spine 2007; 32: 2039-2040.
    • (2007) Spine , vol.32 , pp. 2039-2040
    • Vaccaro, A.R.1    Fehlings, M.G.2
  • 18
    • 0004147553 scopus 로고
    • Brain and Bannister's Clinical Neurology
    • Oxford: Oxford University Press
    • W.R. Brain & R. Bannister. 1992. Brain and Bannister's Clinical Neurology. Oxford: Oxford University Press.
    • (1992)
    • Brain, W.R.1    Bannister, R.2
  • 19
    • 67649371216 scopus 로고    scopus 로고
    • Levodopa-related Wearing-off in Parkinson's Disease: Identification and Management
    • R. Pahwa & K.E. Lyons. Levodopa-related Wearing-off in Parkinson's Disease: Identification and Management. Current Medical Research and Opinion 2009; 25: 841-849.
    • (2009) Current Medical Research and Opinion , vol.25 , pp. 841-849
    • Pahwa, R.1    Lyons, K.E.2
  • 21
    • 84876845791 scopus 로고    scopus 로고
    • For a full account of treatment options see the Parkinson's Disease section of the National Institute of Neurological Disorders website. Available at:
    • For a full account of treatment options see the Parkinson's Disease section of the National Institute of Neurological Disorders website. Available at: http://www.ninds.nih.gov/disorders/parkinsons_disease/detail_parkinsons_disease.htm
  • 22
    • 0035826089 scopus 로고    scopus 로고
    • Transplantation of Embryonic Dopamine Neurons for Severe Parkinson's Disease
    • C.R. Freed. Transplantation of Embryonic Dopamine Neurons for Severe Parkinson's Disease. N Engl J Med 2001; 344: 71-719.
    • (2001) N Engl J Med , vol.344 , pp. 71-719
    • Freed, C.R.1
  • 23
    • 0042837887 scopus 로고    scopus 로고
    • A Double-blind Controlled Trial of Bilateral Fetal Nigral Transplantation in Parkinson's Disease
    • C.W. Olanow et al. A Double-blind Controlled Trial of Bilateral Fetal Nigral Transplantation in Parkinson's Disease. Ann Neurol 2003; 54: 403-414.
    • (2003) Ann Neurol , vol.54 , pp. 403-414
    • Olanow, C.W.1
  • 24
    • 0037435511 scopus 로고    scopus 로고
    • Randomized, Double-Blind Trial of Glial Cell Line-Derived Neurotrophic Factor
    • J.G. Nutt et al. Randomized, Double-Blind Trial of Glial Cell Line-Derived Neurotrophic Factor Neurology 2003; 60: 69-73
    • (2003) Neurology , vol.60 , pp. 69-73
    • Nutt, J.G.1
  • 25
    • 0002352133 scopus 로고    scopus 로고
    • A Double-Blind Randomized Controlled Multicenter Clinical Trial of the Safety and Efficacy of Stereotaxic Intrastriatal Implantation of Fetal Porcine Ventral Mesencephalic Tissue (Neurocelltm-PD) vs Imitation Surgery in Patients with Parkinson Disease (PD)
    • R.L. Watts et al. A Double-Blind Randomized Controlled Multicenter Clinical Trial of the Safety and Efficacy of Stereotaxic Intrastriatal Implantation of Fetal Porcine Ventral Mesencephalic Tissue (Neurocelltm-PD) vs Imitation Surgery in Patients with Parkinson Disease (PD). Parkinsonism Relat Disord 2001; 7: S87.
    • (2001) Parkinsonism Relat Disord , vol.7
    • Watts, R.L.1
  • 26
    • 72949111183 scopus 로고    scopus 로고
    • Dopaminergic Transplantation for Parkinson's Disease: Current Status and Future Prospects
    • C.W. Olanow. Dopaminergic Transplantation for Parkinson's Disease: Current Status and Future Prospects. Ann Neurol 2009; 66: 591-596
    • (2009) Ann Neurol , vol.66 , pp. 591-596
    • Olanow, C.W.1
  • 27
    • 77955617871 scopus 로고    scopus 로고
    • Serotonergic Neurons Mediate Dyskinesia Side Effects in Parkinson's Patients with Neural Transplants
    • M. Politis. Serotonergic Neurons Mediate Dyskinesia Side Effects in Parkinson's Patients with Neural Transplants. Sci Translat Med 2010; 2: 38-46
    • (2010) Sci Translat Med , vol.2 , pp. 38-46
    • Politis, M.1
  • 28
    • 84876877735 scopus 로고    scopus 로고
    • Available at:
    • Available at: http://www.ceregene.com/press_112608.asp10].
  • 29
    • 84876878895 scopus 로고    scopus 로고
    • A naturally occurring protein which facilitates the functioning of dopamine-secreting neurons.
    • A naturally occurring protein which facilitates the functioning of dopamine-secreting neurons.
  • 30
    • 84876866375 scopus 로고    scopus 로고
    • Available at: [Accessed 28 Apr 2010].
    • Available at: [Accessed 28 Apr 2010].http://www.ceregene.com/press-042810.asp
  • 31
    • 41349115535 scopus 로고    scopus 로고
    • Spheramine for Treatment of Parkinson's Disease
    • N.P. Stover & R.L. Watts. Spheramine for Treatment of Parkinson's Disease. Neurother 2008; 5: 252-259
    • (2008) Neurother , vol.5 , pp. 252-259
    • Stover, N.P.1    Watts, R.L.2
  • 32
    • 84876822604 scopus 로고    scopus 로고
    • Which, as with other Phase 1 trials, had looked promising. No peer-reviewed Phase 2 data has been published at the time of writing.
    • Which, as with other Phase 1 trials, had looked promising. No peer-reviewed Phase 2 data has been published at the time of writing.
  • 33
    • 84872212233 scopus 로고    scopus 로고
    • Failed' Clinical Trials Using Sham Brain Surgery Controls
    • P.D. Cohen et al. 'Failed' Clinical Trials Using Sham Brain Surgery Controls. http://oba.od.nih.gov/oba/RAC/meetings/jun2010/SHAM%20surgery%20comments%20combined.pdf2010 32-39.
    • (2010) , pp. 32-39
    • Cohen, P.D.1
  • 34
    • 34250683023 scopus 로고    scopus 로고
    • Safety and Tolerability of Gene Therapy with an Adeno-Associated Virus (AAV) Borne GAD Gene for Parkinson's Disease: an Open Label
    • http://www.medicalnewstoday.com/articles/192625.phpM.G. Kaplitt et al. Safety and Tolerability of Gene Therapy with an Adeno-Associated Virus (AAV) Borne GAD Gene for Parkinson's Disease: an Open Label, Phase I Trial. Lancet 2007; 369: 2097-2105.
    • (2007) Phase I Trial. Lancet , vol.369 , pp. 2097-2105
    • Kaplitt, M.G.1
  • 35
    • 84876885328 scopus 로고    scopus 로고
    • Food and Drug Administration. Code of Federal Regulations Title 21 Section 314.126. Available at:
    • Food and Drug Administration. Code of Federal Regulations Title 21 Section 314.126. Available at: http://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/CFRsearch.cfm?CFRPart=314
  • 36
    • 0036155066 scopus 로고    scopus 로고
    • Surgical 'Placebo' Controls
    • R. Tenery et al. Surgical 'Placebo' Controls. Ann Surg 2002; 235: 303-307.
    • (2002) Ann Surg , vol.235 , pp. 303-307
    • Tenery, R.1
  • 37
    • 2842605198 scopus 로고
    • Internal-Mammary-Artery Ligation for Coronary Insufficiency
    • R. Adams. Internal-Mammary-Artery Ligation for Coronary Insufficiency. N Engl J Med 1958; 258: 113-116
    • (1958) N Engl J Med , vol.258 , pp. 113-116
    • Adams, R.1
  • 38
    • 70449243257 scopus 로고
    • An Evaluation of Internal-Mammary-Artery Ligation by a Double-blind Technic
    • T.L. Cobb et al. An Evaluation of Internal-Mammary-Artery Ligation by a Double-blind Technic. N Engl J Med 1959; 260: 1115-1118
    • (1959) N Engl J Med , vol.260 , pp. 1115-1118
    • Cobb, T.L.1
  • 39
    • 0019497995 scopus 로고
    • Placebo Effect in Surgery for Meniere's Disease
    • J. Thomsen. Placebo Effect in Surgery for Meniere's Disease. Arch Otolaryngol 1981; 107: 271-277.
    • (1981) Arch Otolaryngol , vol.107 , pp. 271-277
    • Thomsen, J.1
  • 41
    • 25144482475 scopus 로고    scopus 로고
    • Ethics, Methodology and the Use of Placebo Controls in Surgical Trials
    • S. Polgar & J. Ng. Ethics, Methodology and the Use of Placebo Controls in Surgical Trials. Brain Res Bull 2005; 67: 290-297
    • (2005) Brain Res Bull , vol.67 , pp. 290-297
    • Polgar, S.1    Ng, J.2
  • 42
    • 0342902205 scopus 로고    scopus 로고
    • Is the Placebo Powerless? - An Analysis of Clinical Trials Comparing Placebo with No Treatment
    • A. Hrjóbartsson & P. Gøtzsche. Is the Placebo Powerless? - An Analysis of Clinical Trials Comparing Placebo with No Treatment. N Engl J Med 2001; 345: 1594-1602
    • (2001) N Engl J Med , vol.345 , pp. 1594-1602
    • Hrjóbartsson, A.1    Gøtzsche, P.2
  • 43
    • 26444454499 scopus 로고    scopus 로고
    • Assessing the Risk of a Necessary Harm
    • O. Rascol. Assessing the Risk of a Necessary Harm. Neurology 2005; 65: 982-983.
    • (2005) Neurology , vol.65 , pp. 982-983
    • Rascol, O.1
  • 44
    • 2342436795 scopus 로고    scopus 로고
    • Ethics and Evidence Based Surgery
    • G. Stirrat. Ethics and Evidence Based Surgery. J Med Ethics 2004; 30: 160-165
    • (2004) J Med Ethics , vol.30 , pp. 160-165
    • Stirrat, G.1
  • 45
    • 77149164495 scopus 로고    scopus 로고
    • Equipoise and Randomisation in Surgery
    • P. Mitchell. Equipoise and Randomisation in Surgery. Br J Neurosurg 2010; 24: 96-97
    • (2010) Br J Neurosurg , vol.24 , pp. 96-97
    • Mitchell, P.1
  • 46
    • 0030665729 scopus 로고    scopus 로고
    • Surgical Procedures and Devices Should be Evaluated in the Same Way as Medical Therapy
    • H. Buchwald. Surgical Procedures and Devices Should be Evaluated in the Same Way as Medical Therapy. Control Clin Trials 1997; 18: 478-487
    • (1997) Control Clin Trials , vol.18 , pp. 478-487
    • Buchwald, H.1
  • 47
    • 0029972491 scopus 로고    scopus 로고
    • Randomized Controlled Trials in Surgery: Issues and Problems
    • R. McLeod et al. Randomized Controlled Trials in Surgery: Issues and Problems. Surgery 1996; 119: 483-486
    • (1996) Surgery , vol.119 , pp. 483-486
    • McLeod, R.1
  • 48
    • 0030228704 scopus 로고    scopus 로고
    • Placebo Orthodoxy in Clinical Research I: Empirical and Methodological Myths
    • B. Freedman, K. Glass & C. Weijer. Placebo Orthodoxy in Clinical Research I: Empirical and Methodological Myths. J Law Med Ethics 1996; 24: 243-251
    • (1996) J Law Med Ethics , vol.24 , pp. 243-251
    • Freedman, B.1    Glass, K.2    Weijer, C.3
  • 49
    • 0034655955 scopus 로고    scopus 로고
    • Placebo Control Groups in Randomized Treatment Trials: A Statistician's Perspective
    • P. Lavori. Placebo Control Groups in Randomized Treatment Trials: A Statistician's Perspective. Biol Psychiatry 2004; 47: 717-723
    • (2004) Biol Psychiatry , vol.47 , pp. 717-723
    • Lavori, P.1
  • 50
    • 0034775154 scopus 로고    scopus 로고
    • Sham Neurosurgery in Patients with Parkinson's Disease: Is it Morally Acceptable?
    • W. Dekkers & G. Boer. Sham Neurosurgery in Patients with Parkinson's Disease: Is it Morally Acceptable? J Med Ethics 2001; 27: 151-156
    • (2001) J Med Ethics , vol.27 , pp. 151-156
    • Dekkers, W.1    Boer, G.2
  • 51
    • 0031764879 scopus 로고    scopus 로고
    • Can Unequal be More Fair? Ethics, Subject Allocation, and Randomised Clinical Trials
    • A. Avins. Can Unequal be More Fair? Ethics, Subject Allocation, and Randomised Clinical Trials. J Med Ethics 1998; 24: 401-408
    • (1998) J Med Ethics , vol.24 , pp. 401-408
    • Avins, A.1
  • 52
    • 0034033796 scopus 로고    scopus 로고
    • Can Unequal be More Fair? A Response to Andrew Avins
    • S. Edwards & D. Braunholtz. Can Unequal be More Fair? A Response to Andrew Avins. J Med Ethics 2000; 26: 179-182.
    • (2000) J Med Ethics , vol.26 , pp. 179-182
    • Edwards, S.1    Braunholtz, D.2
  • 53
    • 34447287864 scopus 로고    scopus 로고
    • General Issues. In Textbook of Clinical Trials
    • D. Machin, S. Day & S. Green, eds. Chichester
    • D. Machin. 2004. General Issues. In Textbook of Clinical Trials. D. Machin, S. Day & S. Green, eds. Chichester: John Wiley and Sons11-44
    • (2004) John Wiley and Sons , pp. 11-44
    • Machin, D.1
  • 54
    • 33745665081 scopus 로고    scopus 로고
    • For Landau, the ethical risks for patients are best limited by longer, more thorough primate model studies. W. Landau. What is the Risk of Sham Surgery in Parkinson Disease Clinical Trials? A Review of Published Reports. Neurology
    • For Landau, the ethical risks for patients are best limited by longer, more thorough primate model studies. W. Landau. What is the Risk of Sham Surgery in Parkinson Disease Clinical Trials? A Review of Published Reports. Neurology 2005; 66: 1788.
    • (2005) , vol.66 , pp. 1788
  • 55
    • 0034573353 scopus 로고    scopus 로고
    • Defining and Describing Benefit Appropriately in Clinical Trials
    • N.M.P. King. Defining and Describing Benefit Appropriately in Clinical Trials. J Law Med Ethics 2000; 28: 332-343.
    • (2000) J Law Med Ethics , vol.28 , pp. 332-343
    • King, N.M.P.1
  • 56
    • 16644378196 scopus 로고    scopus 로고
    • Sham Neurosurgery in Parkinson's Disease: Ethical at the Time
    • J. Fletcher. Sham Neurosurgery in Parkinson's Disease: Ethical at the Time. Am J Bioeth 2003; 3: 54-56.
    • (2003) Am J Bioeth , vol.3 , pp. 54-56
    • Fletcher, J.1
  • 57
    • 0032840634 scopus 로고    scopus 로고
    • Equipoise, Knowledge and Ethics in Clinical Research and Practice
    • R.E. Ashcroft. Equipoise, Knowledge and Ethics in Clinical Research and Practice. Bioethics 1999; 13: 314-326.
    • (1999) Bioethics , vol.13 , pp. 314-326
    • Ashcroft, R.E.1
  • 58
    • 0033598325 scopus 로고    scopus 로고
    • The Ethical Problems with Sham Surgery in Clinical Research
    • R. Macklin. The Ethical Problems with Sham Surgery in Clinical Research. N Engl J Med 1999; 341: 992-996
    • (1999) N Engl J Med , vol.341 , pp. 992-996
    • Macklin, R.1
  • 59
    • 0017369629 scopus 로고
    • Reflections on the Report and Recommendations of the National Commission: Research on the Fetus
    • K. Lebacqz. Reflections on the Report and Recommendations of the National Commission: Research on the Fetus. Vill L Rev 1977; 22: 357-366
    • (1977) Vill L Rev , vol.22 , pp. 357-366
    • Lebacqz, K.1
  • 60
    • 84888017153 scopus 로고    scopus 로고
    • Clarifying the Concepts of Research Ethics.
    • R.J. Levine. Clarifying the Concepts of Research Ethics.
    • Levine, R.J.1
  • 61
    • 84876841873 scopus 로고
    • Hastings Cent Rep
    • Hastings Cent Rep 1979; 9: 21-26
    • (1979) , vol.9 , pp. 21-26
  • 62
    • 84876853015 scopus 로고    scopus 로고
    • However, we follow Weijer's distinction between therapeutic procedures which are administered with the intent of providing direct benefit to subjects, and non-therapeutic procedures which are intended only to assist with answering the study question
    • However, we follow Weijer's distinction between therapeutic procedures which are administered with the intent of providing direct benefit to subjects, and non-therapeutic procedures which are intended only to assist with answering the study question
  • 63
    • 0034574910 scopus 로고    scopus 로고
    • The Ethical Analysis of Risk
    • C. Weijer. The Ethical Analysis of Risk. J Law Med Ethics 2000; 28: 344-361.
    • (2000) J Law Med Ethics , vol.28 , pp. 344-361
    • Weijer, C.1
  • 64
    • 2942711455 scopus 로고    scopus 로고
    • When Are Research Risks Reasonable in Relation to Anticipated Benefits?
    • C. Weijer & P.B. Miller. When Are Research Risks Reasonable in Relation to Anticipated Benefits? Nature Med 2004; 10: 570-573
    • (2004) Nature Med , vol.10 , pp. 570-573
    • Weijer, C.1    Miller, P.B.2
  • 65
    • 84876859514 scopus 로고    scopus 로고
    • United States Department of Health and Human Services. Code of Federal Regulations Title 45 Part 46.102. Available at:
    • United States Department of Health and Human Services. Code of Federal Regulations Title 45 Part 46.102. Available at: http://www.hhs.gov/ohrp/humansubjects/guidance/45cfr46.htm#46.102
  • 66
    • 0036515425 scopus 로고    scopus 로고
    • Placebo Surgery for Parkinson's Disease: Do the Benefits Outweigh the Risks
    • P. Clark. Placebo Surgery for Parkinson's Disease: Do the Benefits Outweigh the Risks? J Law Med Ethics 2002; 30: 58-68.
    • (2002) J Law Med Ethics , vol.30 , pp. 58-68
    • Clark, P.1
  • 67
    • 0036791596 scopus 로고    scopus 로고
    • Sham Surgery Controls: Intracerebral Grafting of Fetal Tissue for Parkinson's Disease and Proposed Criteria for Use of Sham Surgery Controls
    • R. Albin. Sham Surgery Controls: Intracerebral Grafting of Fetal Tissue for Parkinson's Disease and Proposed Criteria for Use of Sham Surgery Controls. J Med Ethics 2002; 28: 322-325.
    • (2002) J Med Ethics , vol.28 , pp. 322-325
    • Albin, R.1
  • 68
    • 0037063111 scopus 로고    scopus 로고
    • Is Placebo Surgery Unethical
    • S. Horng & F.G. Miller. Is Placebo Surgery Unethical? N Engl J Med 2002; 347: 137-139
    • (2002) N Engl J Med , vol.347 , pp. 137-139
    • Horng, S.1    Miller, F.G.2
  • 69
    • 34247116022 scopus 로고    scopus 로고
    • Clinical Equipoise and the Incoherence of Research Ethics
    • F.G. Miller & H. Brody. Clinical Equipoise and the Incoherence of Research Ethics. J Med Philos 2007; 32: 151-165
    • (2007) J Med Philos , vol.32 , pp. 151-165
    • Miller, F.G.1    Brody, H.2
  • 70
    • 0037417240 scopus 로고    scopus 로고
    • The Therapeutic Orientation to Clinical Trials
    • F.G. Miller & D.L. Rosenstein. The Therapeutic Orientation to Clinical Trials. N Engl J Med 2003; 348: 1383-1386.
    • (2003) N Engl J Med , vol.348 , pp. 1383-1386
    • Miller, F.G.1    Rosenstein, D.L.2
  • 71
    • 1242279729 scopus 로고    scopus 로고
    • Sham Surgery: An Ethical Analysis
    • F.G. Miller. Sham Surgery: An Ethical Analysis. Am J Bioeth 2003; 3: 41-48
    • (2003) Am J Bioeth , vol.3 , pp. 41-48
    • Miller, F.G.1
  • 72
    • 16644385298 scopus 로고    scopus 로고
    • Sham Surgery: Not an Oxymoron Am J Bioeth
    • C. Kowalski. Sham Surgery: Not an Oxymoron Am J Bioeth 2003; 3: W8-W9
    • (2003) , vol.3
    • Kowalski, C.1
  • 73
    • 34247159822 scopus 로고    scopus 로고
    • Clinical Equipoise: Foundational Requirement or Fundamental Error? In Oxford Handbook of Bioethics
    • B. Steinbock, ed. Oxford: Oxford University Press.
    • A.J. London. 2007. Clinical Equipoise: Foundational Requirement or Fundamental Error? In Oxford Handbook of Bioethics. B. Steinbock, ed. Oxford: Oxford University Press.
    • (2007)
    • London, A.J.1
  • 74
    • 0036513899 scopus 로고    scopus 로고
    • Avoiding a Jekyll-and-Hyde Approach to the Ethics of Clinical Research and Practice
    • T. Lemmens & P.B. Miller. Avoiding a Jekyll-and-Hyde Approach to the Ethics of Clinical Research and Practice. Am J Bioeth 2002; 2: 14-17
    • (2002) Am J Bioeth , vol.2 , pp. 14-17
    • Lemmens, T.1    Miller, P.B.2
  • 75
    • 0036513879 scopus 로고    scopus 로고
    • Clinical Research Should Not Be Permitted to Escape the Ethical Orbit of Clinical Care
    • D. Steinberg. Clinical Research Should Not Be Permitted to Escape the Ethical Orbit of Clinical Care. Am J Bioeth 2002; 2: 27-28.
    • (2002) Am J Bioeth , vol.2 , pp. 27-28
    • Steinberg, D.1
  • 76
    • 34247137485 scopus 로고    scopus 로고
    • Equipoise and the Duty of Care in Clinical Research: A Philosophical Response to Our Critics
    • P.B. Miller & C. Weijer. Equipoise and the Duty of Care in Clinical Research: A Philosophical Response to Our Critics. J Med Philos 2007; 32: 117-133.
    • (2007) J Med Philos , vol.32 , pp. 117-133
    • Miller, P.B.1    Weijer, C.2
  • 77
    • 16644367102 scopus 로고    scopus 로고
    • The Physician's Role, 'Sham Surgery', and Trust: a Conflict of Duties
    • C. Clark. The Physician's Role, 'Sham Surgery', and Trust: a Conflict of Duties? Am J Bioeth 2003; 3: 57-58
    • (2003) Am J Bioeth , vol.3 , pp. 57-58
    • Clark, C.1
  • 78
    • 0036513820 scopus 로고    scopus 로고
    • When Argument Fails
    • C. Weijer. When Argument Fails. Am J Bioeth 2002; 2: 10-11
    • (2002) Am J Bioeth , vol.2 , pp. 10-11
    • Weijer, C.1
  • 79
    • 70349510598 scopus 로고    scopus 로고
    • Clinical and Research Ethics as Moral Strangers
    • M. Kottow. Clinical and Research Ethics as Moral Strangers. Arch Immunol Ther Exp 2009; 57: 257-164
    • (2009) Arch Immunol Ther Exp , vol.57 , pp. 257-164
    • Kottow, M.1
  • 80
    • 0036513940 scopus 로고    scopus 로고
    • Effective Trial Design Need Not Conflict With Good Patient Care
    • K. Glass & D. Waring. Effective Trial Design Need Not Conflict With Good Patient Care. Am J Bioeth 2002; 2: 25-26
    • (2002) Am J Bioeth , vol.2 , pp. 25-26
    • Glass, K.1    Waring, D.2
  • 81
    • 84876837189 scopus 로고    scopus 로고
    • Resolving the Inherent Dissonance Between the Doctor's Roles as Healer and Researcher: A Proposal
    • In Research on Human Subjects: Ethics, Law and Social Policy. D. Weisstub, ed. Oxford: Pergamon; Cf. D. Lenrow. The Treating Physician As Researcher: Is Assuming This Dual Role a Violation of the Nuremberg Code?
    • D. Sprumont. 1998. Resolving the Inherent Dissonance Between the Doctor's Roles as Healer and Researcher: A Proposal. In Research on Human Subjects: Ethics, Law and Social Policy. D. Weisstub, ed. Oxford: Pergamon; Cf. D. Lenrow. The Treating Physician As Researcher: Is Assuming This Dual Role a Violation of the Nuremberg Code? Temple J Sci Tech Env Law 1996; 25: 15-48
    • (1998) Temple J Sci Tech Env Law , vol.25 , pp. 15-48
    • Sprumont, D.1
  • 82
    • 16644401867 scopus 로고    scopus 로고
    • Sham Surgery in Research: A Surgeon's View
    • P. Angelos. Sham Surgery in Research: A Surgeon's View. Am J Bioeth 2003; 3: 65-66
    • (2003) Am J Bioeth , vol.3 , pp. 65-66
    • Angelos, P.1
  • 83
    • 84876818534 scopus 로고    scopus 로고
    • This is the case even if the participant is in the placebo arm, since the placebo is intrinsically active rather than inert.
    • This is the case even if the participant is in the placebo arm, since the placebo is intrinsically active rather than inert.
  • 84
    • 16644399920 scopus 로고    scopus 로고
    • The Sham Surgery Debate and the Moral Complexity of Risk-benefit Analysis
    • S. Kim. The Sham Surgery Debate and the Moral Complexity of Risk-benefit Analysis. Am J Bioeth 2003; 3: 68-70.
    • (2003) Am J Bioeth , vol.3 , pp. 68-70
    • Kim, S.1
  • 85
    • 0003663231 scopus 로고    scopus 로고
    • Principles of Biomedical Ethics
    • Sixth edn. Oxford: Oxford University Press.
    • T.L. Beauchamp & J.F. Childress. 2009. Principles of Biomedical Ethics, Sixth edn. Oxford: Oxford University Press.
    • (2009)
    • Beauchamp, T.L.1    Childress, J.F.2
  • 86
    • 0004305896 scopus 로고
    • Groundwork of the Metaphysics of Morals
    • In M. Gregor (translator). Cambridge: Cambridge University Press.
    • I. Kant. 1785. Groundwork of the Metaphysics of Morals. In M. Gregor (translator). Cambridge: Cambridge University Press.1998
    • (1785)
    • Kant, I.1
  • 87
    • 0038607086 scopus 로고    scopus 로고
    • Cambridge Medical Ethics Workbook
    • Second edn. Cambridge: Cambridge University Press.
    • M. Parker, R. Huxtable & D. Dickenson. 2010. Cambridge Medical Ethics Workbook, Second edn. Cambridge: Cambridge University Press.
    • (2010)
    • Parker, M.1    Huxtable, R.2    Dickenson, D.3
  • 88
    • 0020390058 scopus 로고
    • The Therapeutic Misconception: Informed Consent in Psychiatric Research
    • P.S. Appelbaum, C.H. Roth & C.W. Lidz. The Therapeutic Misconception: Informed Consent in Psychiatric Research. Int J Law Psychiatry 1982; 5: 319-329
    • (1982) Int J Law Psychiatry , vol.5 , pp. 319-329
    • Appelbaum, P.S.1    Roth, C.H.2    Lidz, C.W.3
  • 89
    • 12844261878 scopus 로고    scopus 로고
    • The Therapeutic Misconception: Problems and Solutions
    • C.W. Lidz, & P.S. Appelbaum. The Therapeutic Misconception: Problems and Solutions. Med Care 2002; 40(Suppl): 55-63.
    • (2002) Med Care , vol.40 , Issue.SUPPL. , pp. 55-63
    • Lidz, C.W.1    Appelbaum, P.S.2
  • 90
    • 74149089306 scopus 로고    scopus 로고
    • Long Term Understanding of Study Information in Research Participants with Parkinson's Disease
    • B. Ravina et al. Long Term Understanding of Study Information in Research Participants with Parkinson's Disease. Parkinsonism Relat Disord 2010; 16:60-63
    • (2010) Parkinsonism Relat Disord , vol.16 , pp. 60-63
    • Ravina, B.1
  • 91
    • 36048933619 scopus 로고    scopus 로고
    • Beyond 'Misunderstanding': Written Information and Decisions About Taking Part in a Genetic Epidemiology Study
    • M. Dixon-Woods et al. Beyond 'Misunderstanding': Written Information and Decisions About Taking Part in a Genetic Epidemiology Study. Soc Sci Med 2007; 65: 2212-2222
    • (2007) Soc Sci Med , vol.65 , pp. 2212-2222
    • Dixon-Woods, M.1
  • 92
    • 56749157971 scopus 로고    scopus 로고
    • I Don't Like That, it's Tricking People Too Much. .': Acute Informed Consent to Participation in a Trial of Thrombolysis for Stroke
    • M. Mangset. I Don't Like That, it's Tricking People Too Much. .': Acute Informed Consent to Participation in a Trial of Thrombolysis for Stroke. J Med Ethics 2008; 34: 751-756.
    • (2008) J Med Ethics , vol.34 , pp. 751-756
    • Mangset, M.1
  • 93
    • 84876873951 scopus 로고    scopus 로고
    • Method for a Study of the Therapeutic Misconception
    • Worcester, MA: University of Massachusetts Medical School Center for Mental Health Services Research; D.T. Penman et al. Informed Consent for Investigational Chemotherapy: Patients' and Physicians' Perceptions
    • T. Grisso. 2001. Method for a Study of the Therapeutic Misconception. Worcester, MA: University of Massachusetts Medical School Center for Mental Health Services Research; D.T. Penman et al. Informed Consent for Investigational Chemotherapy: Patients' and Physicians' Perceptions. J Clin Oncol 1984; 2: 849-855
    • (2001) J Clin Oncol , vol.2 , pp. 849-855
    • Grisso, T.1
  • 94
    • 0029927575 scopus 로고    scopus 로고
    • The Impact of Disease Severity on the Informed Consent Process in Clinical Research
    • M. Schaeffer et al. The Impact of Disease Severity on the Informed Consent Process in Clinical Research. Am J Med 1996; 100: 261-268.
    • (1996) Am J Med , pp. 261-268
    • Schaeffer, M.1
  • 95
    • 1442311081 scopus 로고    scopus 로고
    • Therapeutic Misconception and the Appreciation of Risks in Clinical Trials
    • C.W. Lidz et al. Therapeutic Misconception and the Appreciation of Risks in Clinical Trials. Soc Sci Med 2004; 58: 1689-1697
    • (2004) Soc Sci Med , vol.58 , pp. 1689-1697
    • Lidz, C.W.1
  • 96
    • 0035944839 scopus 로고    scopus 로고
    • Quality of Informed Consent in Cancer Clinical Trials: A Cross-sectional Survey
    • S.L. Joffe. Quality of Informed Consent in Cancer Clinical Trials: A Cross-sectional Survey. Lancet 2001; 358: 1772-1777.
    • (2001) Lancet , vol.358 , pp. 1772-1777
    • Joffe, S.L.1
  • 97
    • 0036302082 scopus 로고    scopus 로고
    • Why don't they just tell me straight, why allocate it?' The Struggle to Make Sense of Participating in a Randomised Controlled Trial
    • K. Featherstone & J.L. Donovan. 'Why don't they just tell me straight, why allocate it?' The Struggle to Make Sense of Participating in a Randomised Controlled Trial. Soc Sci Med 2002; 55: 709-719.
    • (2002) Soc Sci Med , vol.55 , pp. 709-719
    • Featherstone, K.1    Donovan, J.L.2
  • 98
    • 0030227764 scopus 로고    scopus 로고
    • Trust: The Fragile Foundation of Contemporary Biomedical Research
    • N.E. Kass et al. Trust: The Fragile Foundation of Contemporary Biomedical Research. Hastings Cent Rep 1996; 26: 25-29
    • (1996) Hastings Cent Rep , vol.26 , pp. 25-29
    • Kass, N.E.1
  • 99
    • 84876817723 scopus 로고    scopus 로고
    • While voluntariness in a legal sense is concerned with undue external influence upon a person's decision-making, we subscribe to Olsaretti's definition of voluntariness
    • While voluntariness in a legal sense is concerned with undue external influence upon a person's decision-making, we subscribe to Olsaretti's definition of voluntariness
  • 100
    • 0032341560 scopus 로고    scopus 로고
    • Freedom, Force and Choice: Against the Rights-based Definition of Voluntariness
    • S. Olsaretti. Freedom, Force and Choice: Against the Rights-based Definition of Voluntariness. J Polit Phil 1998; 6: 53-78
    • (1998) J Polit Phil , vol.6 , pp. 53-78
    • Olsaretti, S.1
  • 101
    • 84876848745 scopus 로고    scopus 로고
    • Olsaretti argues that an individual's choice among options may be free so long as it is not subject to influence by other people. It may still be a non-voluntary choice, however, if it is made because no other option was acceptable other than the option ultimately chosen.
    • Olsaretti argues that an individual's choice among options may be free so long as it is not subject to influence by other people. It may still be a non-voluntary choice, however, if it is made because no other option was acceptable other than the option ultimately chosen.
  • 102
    • 0003542911 scopus 로고
    • Communication and Medical Practice: Social Relations and the Clinic
    • London: Sage Publications; P. Atkinson. Medical Talk and Medical Work. London: Sage Publications.
    • D. Silverman. 1987. Communication and Medical Practice: Social Relations and the Clinic. London: Sage Publications; P. Atkinson. Medical Talk and Medical Work. London: Sage Publications.1995
    • (1987)
    • Silverman, D.1
  • 103
    • 0036513849 scopus 로고    scopus 로고
    • Exploitation and the Ethics of Clinical Trials
    • D.B. Resnik. Exploitation and the Ethics of Clinical Trials. Am J Bioeth 2002; 2: 28-29
    • (2002) Am J Bioeth , vol.2 , pp. 28-29
    • Resnik, D.B.1
  • 104
    • 84888065764 scopus 로고    scopus 로고
    • A. Wertheimer. 2001. http://plato.stanford.edu/entries/exploitation/
    • (2001)
    • Wertheimer, A.1
  • 105
    • 23944518089 scopus 로고    scopus 로고
    • The Ethics of Placebo-controlled Trials: A Comparison of Inert and Active Placebo Controls
    • S.J.L. Edwards et al. The Ethics of Placebo-controlled Trials: A Comparison of Inert and Active Placebo Controls. World J Surg 2005; 29: 610-614
    • (2005) World J Surg , vol.29 , pp. 610-614
    • Edwards, S.J.L.1
  • 106
    • 33644932150 scopus 로고    scopus 로고
    • Restricted Treatments, Inducements and Research Participation
    • S.J.L. Edwards. Restricted Treatments, Inducements and Research Participation. Bioethics 2006; 20: 77-91.
    • (2006) Bioethics , vol.20 , pp. 77-91
    • Edwards, S.J.L.1
  • 107
    • 0031891682 scopus 로고    scopus 로고
    • Meta-analysis of Trials Comparing Antidepressants with Active Placebos
    • J. Moncrieff, S. Wessely & R. Hardy. Meta-analysis of Trials Comparing Antidepressants with Active Placebos. Br J Psychiatry 1998; 172: 227-231.
    • (1998) Br J Psychiatry , vol.172 , pp. 227-231
    • Moncrieff, J.1    Wessely, S.2    Hardy, R.3
  • 108
    • 34250752739 scopus 로고    scopus 로고
    • Ethical Issues in Clinical Neuroscience Research: A Patient's Perspective
    • P. Cohen et al. Ethical Issues in Clinical Neuroscience Research: A Patient's Perspective. Neurother 2007; 4: 537-544
    • (2007) Neurother , vol.4 , pp. 537-544
    • Cohen, P.1
  • 109
    • 1342287920 scopus 로고    scopus 로고
    • Research Ethics Committees and Paternalism
    • See S.J.L. Edwards, S. Kirchin & R. Huxtable. Research Ethics Committees and Paternalism. J Med Ethics 2004; 30: 88-91.
    • (2004) J Med Ethics , vol.30 , pp. 88-91
    • Edwards, S.J.L.1    Kirchin, S.2    Huxtable, R.3
  • 110
    • 21744453019 scopus 로고    scopus 로고
    • What is the Role of the Research Ethics Committee? Paternalism, Inducements, and Harm in Research Ethics
    • E. Garrard & A. Dawson. What is the Role of the Research Ethics Committee? Paternalism, Inducements, and Harm in Research Ethics. J Med Ethics 2005; 31: 419-423.
    • (2005) J Med Ethics , vol.31 , pp. 419-423
    • Garrard, E.1    Dawson, A.2
  • 111
    • 0042594499 scopus 로고    scopus 로고
    • Seven Vulnerabilities in the Pediatric Research Subject
    • K. Kipnis. Seven Vulnerabilities in the Pediatric Research Subject. Theor Med 2003; 24: 107-120.
    • (2003) Theor Med , vol.24 , pp. 107-120
    • Kipnis, K.1
  • 112
    • 84876867539 scopus 로고    scopus 로고
    • Online Ethics Center for Engineering. Chapter 4: Assessing Risks and Potential Benefits and Evaluating Vulnerability (Research Involving Human Participants V1). 14 June 2006. National Academy of Engineering. Available at:
    • Online Ethics Center for Engineering. Chapter 4: Assessing Risks and Potential Benefits and Evaluating Vulnerability (Research Involving Human Participants V1). 14 June 2006. National Academy of Engineering. Available at: http://www.onlineethics.org/Topics/RespResearch/ResResources/nbacindex/nbachindex/hchapter4.aspx
  • 113
    • 16644399921 scopus 로고    scopus 로고
    • Sham Surgery and Genuine Standards of Care: Can the Two Be Reconciled?
    • A.J. London & J.B. Kadane. Sham Surgery and Genuine Standards of Care: Can the Two Be Reconciled? Am J Bioeth 2003; 3: 61-64.
    • (2003) Am J Bioeth , vol.3 , pp. 61-64
    • London, A.J.1    Kadane, J.B.2
  • 114
    • 0034737962 scopus 로고    scopus 로고
    • What Makes Clinical Research Ethical
    • E. Emanuel, D. Wendler & C. Grady. What Makes Clinical Research Ethical? JAMA 2000; 283: 2701-2711
    • (2000) JAMA , vol.283 , pp. 2701-2711
    • Emanuel, E.1    Wendler, D.2    Grady, C.3
  • 115
    • 16644398069 scopus 로고    scopus 로고
    • Social Aspects of Sham Surgeries
    • H.S. Leeds. Social Aspects of Sham Surgeries. Am J Bioeth 2003; 3: 70-71.
    • (2003) Am J Bioeth , vol.3 , pp. 70-71
    • Leeds, H.S.1
  • 116
    • 25144497439 scopus 로고    scopus 로고
    • Science and Ethics of Sham Surgery: A Survey of Parkinson Disease Clinical Researchers
    • S.Y.H. Kim et al. Science and Ethics of Sham Surgery: A Survey of Parkinson Disease Clinical Researchers. Arch Neurol 2005; 62: 1357-1360.
    • (2005) Arch Neurol , vol.62 , pp. 1357-1360
    • Kim, S.Y.H.1
  • 117
    • 84876848747 scopus 로고    scopus 로고
    • A majority would therefore presumably disagree with the sham group in the Neurologix trial which included cannula insertion into the brain and injection of saline solution.
    • A majority would therefore presumably disagree with the sham group in the Neurologix trial which included cannula insertion into the brain and injection of saline solution.
  • 118
    • 33750353570 scopus 로고    scopus 로고
    • Studying Neurosurgical Implants for Parkinson Disease: A Question of Design
    • A.W. Prehn et al. Studying Neurosurgical Implants for Parkinson Disease: A Question of Design. Neurology 2006; 67: 1503-1505.
    • (2006) Neurology , vol.67 , pp. 1503-1505
    • Prehn, A.W.1
  • 119
    • 84888035117 scopus 로고    scopus 로고
    • Is Sham Surgery for Parkinson Disease Justifiable
    • K. Samson. Is Sham Surgery for Parkinson Disease Justifiable? Neurology Today 2005; 5: 5-7.
    • (2005) Neurology Today , vol.5
    • Samson, K.1
  • 120
    • 39549090439 scopus 로고    scopus 로고
    • Ethics of Sham Surgery: Perspective of Patients
    • S.A. Frank et al. Ethics of Sham Surgery: Perspective of Patients. Mov Disord 2007; 23: 63-68.
    • (2007) Mov Disord , vol.23 , pp. 63-68
    • Frank, S.A.1
  • 121
    • 84876837288 scopus 로고    scopus 로고
    • E.g. the use of a hypothetical scenario; failure to assess illness severity of participants; response bias, through self-selection of participants, with the participants also not necessarily constituting a sample that is representative of the general public.
    • E.g. the use of a hypothetical scenario; failure to assess illness severity of participants; response bias, through self-selection of participants, with the participants also not necessarily constituting a sample that is representative of the general public.
  • 122
    • 84876874395 scopus 로고    scopus 로고
    • The first author has conducted qualitative empirical research into UK patients' perspectives on participation in sham surgery in PD as part of a current PhD thesis: The Ethical Implications of Sham Neurosurgery in Patients with Parkinson's Disease.
    • The first author has conducted qualitative empirical research into UK patients' perspectives on participation in sham surgery in PD as part of a current PhD thesis: The Ethical Implications of Sham Neurosurgery in Patients with Parkinson's Disease.


* 이 정보는 Elsevier사의 SCOPUS DB에서 KISTI가 분석하여 추출한 것입니다.