Many factors will be part of a woman’s decision to use a particular hormone product—her age, her risks, her preferences, available treatment options, and the cost of the product. Do her potential benefits outweigh her potential risks? Only after examining and understanding her own situation and after a thorough consultation with her clinician can a woman make the best treatment choice. As new therapies and guidelines are available, and as a woman’s body changes over time, reevaluation and adjustments should be made.
With respect to a particular trial, a physician may or may not be in equipoise. In recognition of his fiduciary status derivative of the physician-patient relationship, he may be uncertain whether to offer participation to his patient. Even if he is not in equipoise, he should inform his patient of the availability of a trial, thus fulfilling the obligation to provide information concerning alternatives to any proposed treatments. Indeed, it has been proposed that this is a moral requirement ( 15 ). Analogously, the potential participant should be provided all the necessary information about the trial so that the patient, expressive of his personal medical goals and values, may determine whether he is in equipoise and thus willing to undergo randomization.