In medicine, observational evidence is actually better and far more ethical than the RCT. (Which simply dooms the terminally ill to fake treatment.) You just need large datasets and an agile culture that's responsive to new input. Don't forget that RCTs are very far from perfect and issues -- sometimes literally fatal issues -- have later turned up via observational evidence in large cohorts. Vioxx, for instance. Man…
This is just nonsense. First, everyone in a trial is informed of the situation. It's not "unethical" unless you lie about it. If you participate in a trial, you do so knowing that you might not get the experimental drug. It's a selfless, honorable thing to do, and we shouldn't be framing it as some kind of scam.
Second, we don't give terminally ill people "fake treatment" (placebo trials). We give them current standard of care. Giving someone a placebo trial doesn't prove anything that would change clinical practice, because you want to know if the drug works better than what is out there today. Rarely is that standard of care "nothing", and this (bad controls) is actually a primary reason that a lot of drug company trials are rejected by the FDA.
If I didn't see the Wall Street Journal editorial board repeating the same garbage in defense of patent medicines, I'd write you off as simply having a sophomoric understanding of how trials work. I'm convinced that someone is driving this absurd narrative.