We thank Dr Reekers for his comments. We recognize and respect that differing views regarding the ethical permissibility of clinical research in CCSVI exist. As we stated, a strong scientific case has been made against CCSVI as a causative factor in multiple sclerosis, and we shared our doubt regarding its validity. Nonetheless, published clinical research suggests that endovascular intervention may be effective in at least a portion of involved patients. Therefore, we argue that a vital prerequisite for research to be conducted (ie, equipoise) exists. Equipoise in this instance is not an individual's sense of ambivalence regarding the efficacy of a novel treatment, but rather the existence of uncertainty within the scientific community regarding its efficacy compared with existing therapies or placebo.
http://archneur.jamanetwork.com/article ... id=1214757
CCSVI should be researched because equipoise exists.
Clinical equipoise, also known as the principle of equipoise, provides the ethical basis for medical research that involves assigning patients to different treatment arms of a clinical trial. The term was first used by Benjamin Freedman in 1987.
In short, clinical equipoise means that there is genuine uncertainty in the expert medical community over whether a treatment will be beneficial. This applies also for off-label treatments performed before or during their required clinical trials.