Confronting Ethical and Regulatory Challenges of Emergency Care Research With Conscious Patients.

TitleConfronting Ethical and Regulatory Challenges of Emergency Care Research With Conscious Patients.
Publication TypeJournal Article
Year of Publication2016
AuthorsDickert NW, Brown J, Cairns CB, Eaves-Leanos A, Goldkind SF, Kim SYH, Nichol G, O'Conor KJ, Scott JD, Sinert R, Wendler D, Wright DW, Silbergleit R
JournalAnn Emerg Med
Volume67
Issue4
Pagination538-45
Date Published2016 Apr
ISSN Number1097-6760
Abstract

<p>Barriers to informed consent are ubiquitous in the conduct of emergency care research across a wide range of conditions and clinical contexts. They are largely unavoidable; can be related to time constraints, physical symptoms, emotional stress, and cognitive impairment; and affect patients and surrogates. US regulations permit an exception from informed consent for certain clinical trials in emergency settings, but these regulations have generally been used to facilitate trials in which patients are unconscious and no surrogate is available. Most emergency care research, however, involves conscious patients, and surrogates are often available. Unfortunately, there is neither clear regulatory guidance nor established ethical standards in regard to consent in these settings. In this report-the result of a workshop convened by the National Institutes of Health Office of Emergency Care Research and Department of Bioethics to address ethical challenges in emergency care research-we clarify potential gaps in ethical understanding and federal regulations about research in emergency care in which limited involvement of patients or surrogates in enrollment decisions is possible. We propose a spectrum of approaches directed toward realistic ethical goals and a research and policy agenda for addressing these issues to facilitate clinical research necessary to improve emergency care.</p>

DOI10.1016/j.annemergmed.2015.10.026
Alternate JournalAnn Emerg Med
PubMed ID26707358
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