The challenges of obtaining consent in emergency care research

It is not possible to consent a patient for emergency research in advance of their acute illness, as the clinical events are not predictable. We discuss the problems of undertaking research in an emergency care setting, where patients lack the capacity to provide consent but require time critical i...

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Main Authors: Fatovich, Daniel, Finn, Judith, Webb, Steve, MacDonald, Stephen
Format: Journal Article
Published: 2020
Online Access:http://hdl.handle.net/20.500.11937/80334
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author Fatovich, Daniel
Finn, Judith
Webb, Steve
MacDonald, Stephen
author_facet Fatovich, Daniel
Finn, Judith
Webb, Steve
MacDonald, Stephen
author_sort Fatovich, Daniel
building Curtin Institutional Repository
collection Online Access
description It is not possible to consent a patient for emergency research in advance of their acute illness, as the clinical events are not predictable. We discuss the problems of undertaking research in an emergency care setting, where patients lack the capacity to provide consent but require time critical interventions. There is no settled definition of what constitutes ‘research’ as distinct from ‘treatment’. In fact their relationship is a continuum that demands similar level of oversight for both. We provide examples where the usual requirement for written informed consent means the trial underestimated benefits, because the treatment would normally be given without delay. Consent rituals that delay the start of trial treatments may in fact be unethical and offend against the Declaration of Helsinki. Clinical research delivers improved patient outcomes irrespective of the randomised group. This is currently under threat by a lack of consistency across jurisdictions in the interpretation of the relevant legislation.
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spelling curtin-20.500.11937-803342020-12-17T07:16:06Z The challenges of obtaining consent in emergency care research Fatovich, Daniel Finn, Judith Webb, Steve MacDonald, Stephen It is not possible to consent a patient for emergency research in advance of their acute illness, as the clinical events are not predictable. We discuss the problems of undertaking research in an emergency care setting, where patients lack the capacity to provide consent but require time critical interventions. There is no settled definition of what constitutes ‘research’ as distinct from ‘treatment’. In fact their relationship is a continuum that demands similar level of oversight for both. We provide examples where the usual requirement for written informed consent means the trial underestimated benefits, because the treatment would normally be given without delay. Consent rituals that delay the start of trial treatments may in fact be unethical and offend against the Declaration of Helsinki. Clinical research delivers improved patient outcomes irrespective of the randomised group. This is currently under threat by a lack of consistency across jurisdictions in the interpretation of the relevant legislation. 2020 Journal Article http://hdl.handle.net/20.500.11937/80334 restricted
spellingShingle Fatovich, Daniel
Finn, Judith
Webb, Steve
MacDonald, Stephen
The challenges of obtaining consent in emergency care research
title The challenges of obtaining consent in emergency care research
title_full The challenges of obtaining consent in emergency care research
title_fullStr The challenges of obtaining consent in emergency care research
title_full_unstemmed The challenges of obtaining consent in emergency care research
title_short The challenges of obtaining consent in emergency care research
title_sort challenges of obtaining consent in emergency care research
url http://hdl.handle.net/20.500.11937/80334