When is it ethical to randomly determine the provision of a treatment to people in an experiment? Researchers designing such experiments often appeal to the principle of equipoise, which means “that there is genuine uncertainty in the expert medical community over whether a treatment will be beneficial.” This principle captures a straightforward ethical logic: we know that ARVs are effective in treating AIDS, so it would be unethical to design an experiment that denies some AIDS patients access to ARVs. In contrast, until recently we did not know that starting ARVs immediately had health benefits for people with HIV who do know yet have AIDS. The experiment that proved that this was the case was entirely ethical to conduct.
This approach works well for medical trials, because doctors have the joint social roles of studying which treatments are effective and actually providing people with the treatments that work. Social…
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Utopia, you are standing in it! 
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