Abstract
We agree with some of the points made by Stein and Ray but disagree about their conclusions. As clinicians, we recognize that fractures reduce the quality of life of patients with osteoporosis and increase the risk of coexisting conditions. Hence, we believe it is not ethical to randomly assign high-risk patients to receive placebo in a trial, nor do we believe that approval by an institutional review board or informed consent from the patient automatically makes a trial ethical. We also agree that physicians should not recruit their own patients into trials. However, we disagree on several points. First, although . . .
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