Despite the fact that he appears to have fabricated at least half of the patients in a 2005 Lancet study , Norwegian researcher Jon Sudbo has an opinion on the ethics of 'rigorously conducted clinical trials' ? or at least he did in 2001. The results of such trials, he wrote in a letter to the New England Journal of Medicine ? which is now investigating his work published there ? 'make up the foundation for what we like to term 'evidence-based medicine.''

Because less than 1% of patients who take part in trials are elderly, he continues, 'the 'evidence' on which we base our future treatment may not apply to most of the patients we will serve in the future ? the growing population of elderly persons. Consequently, physicians may decide not to offer a treatment because the evidence does not support its use in clinical circumstances such as advanced age. This matter, too, merits ethical consideration.'

The other option, of course, is just fabricating research subjects so the results can be more easily generalized.