RCTs for policy in India - Ethical Considerations, Methodological Concerns and Alternative Approaches

Abstract

Randomised controlled trials (RCTs) have become a popular methodological choice for policy analysis in the developing world. This paper describes the various ethical and methodological considerations when choosing to adopt RCTs for policy decisions through a review of literature in multiple disciplines. Unlike previous critical analysis of RCTs, this paper contextualises its critique to India, a country that has been the site of well over a hundred RCTs. Through illustrations of recent Indian policy RCTs on corruption, livelihoods, Public Distribution System, conflict and others, the paper raises concern about violations of ethical requirements like equipoise, informed consent, data harms, human costs to research participants and research staff. The paper discusses methodological limitations of RCTs for Indian policy making including heterogeneity, researcher effects, generalisability, policy-relevant unobserved mechanisms and other socio-political considerations. The paper ends with a description of alternative approaches and a simple checklist for practitioners, specifically policy makers, to assess the feasibility of RCTs for informing decision making in their context.