During an epidemic in a foreign country, a Canadian researcher proposes a protocol that randomly assigns employees to mosquito nets (Group A) or no nets (Group B) to assess the relative incidence of the virus. Is this protocol ethically permissible to test the hypothesis?

• A. Yes
• B. No
• C. Not sure
• D. Not applicable

Answer: (A)

In research ethics, you can conduct a randomized trial when there is genuine uncertainty about whether the intervention will help, and the study is designed to protect participants. Here, the researchers want to see if mosquito nets reduce infection by the virus. If there is no proven protective effect of nets against this virus, there is true equipoise—no one knows which approach will yield a lower incidence. That uncertainty is exactly what justifies random assignment, because it allows a fair comparison and credible evidence generation.

Ethical permissibility hinges on safeguards: obtaining informed consent so participants understand the risks and potential benefits; independent ethics review; careful risk minimization and monitoring for adverse outcomes; and plans to ensure access to standard protections after the trial or to provide nets to participants if warranted. It’s also important that the study does not exploit participants in a foreign country and that there is fair selection and benefit to the community.

If nets were already proven protective against this virus, withholding them would be unethical. But with genuine uncertainty about their effect in this epidemic context, a well-designed randomized trial can be ethically permissible under TCPS 2 principles (respect for persons, welfare, and justice) and with appropriate protections in place.