Are Randomized Poverty-Alleviation Experiments Ethical?
When this year's Nobel Memorial Prize in Economic Sciences was awarded to three pioneers in using randomized controlled trials to fight poverty in developing countries, the choice revived questions about the ethics of the method. Three questions, in particular, need to be addressed.
PRINCETON – Last month, the Nobel Memorial Prize in Economic Sciences was awarded to three pioneers in using randomized controlled trials (RCTs) to fight poverty in low-income countries: Abhijit Banerjee, Esther Duflo, and Michael Kremer. In RCTs, researchers randomly choose a group of people to receive an intervention, and a control group of people who do not, and then compare the outcomes. Medical researchers use this method to test new drugs or surgical techniques, and anti-poverty researchers use it alongside other methods to discover which policies or interventions are most effective. Thanks to the work of Banerjee, Duflo, Kremer, and others, RCTs have become a powerful tool in the fight against poverty.
But the use of RCTs does raise ethical questions, because they require randomly choosing who receives a new drug or aid program, and those in the control group often receive no intervention or one that may be inferior. One could object to this on principle, following Kant’s claim that it is always wrong to use human beings as a means to an end; critics have argued that RCTs “sacrifice the well-being of study participants in order to ‘learn.’”
Rejecting all RCTs on this basis, however, would also rule out the clinical trials on which modern medicine relies to develop new treatments. In RCTs, participants in both the control and treatment groups are told what the study is about, sign up voluntarily, and can drop out at any time. To prevent people from choosing to participate in such trials would be excessively paternalistic, and a violation of their personal freedom.