Informed consent for research obtained during the intensive care unit stay
- PMID: 17156444
- PMCID: PMC1794486
- DOI: 10.1186/cc5120
Informed consent for research obtained during the intensive care unit stay
Abstract
Introduction: Patients in the intensive care unit (ICU) may be in an inadequate condition to give their informed consent for research. The aim of this study was to analyse the ability to recall participation in a clinical trial for which ICU patients had given their consent.
Methods: The data presented are a two-step observational study: first, a protocolled informed consent procedure was conducted then the informed consent was given by the patient, and second, a patient interview was held 10 +/- 2 days later by the same investigator. The primary endpoints were the ability to recall their participation in the clinical trial, as well as its purpose and related risks. As secondary endpoints, we investigated whether asking questions about the clinical trial or reading the informative leaflet was related to the recall. To be included in the study, the patient had to have a Glasgow Coma Scale score of 15, be fully oriented and free of mechanical ventilation, and be judged competent by both the investigator and the attending physician. Patients admitted to the ICU after major surgery or trauma were eligible. However, patients who refused to participate, or those whose next-of-kin gave consent, were excluded.
Results: Of the 44 patients, 35 (80%) recognized, 10 to 12 days after informed consent had been obtained, that they had participated in the clinical trial, but only 14 out of 44 (32%) could recall the clinical trial purpose and its related risks. More patients with complete recall had read the informative leaflet or asked at least one question before signing the informed consent. Asking at least one question was associated with complete recall.
Conclusion: Our results confirm that obtaining informed consent for research during an ICU stay is associated with poor patient recall of participation in a clinical trial and its components (purpose and risk). Whether encouraging reading the informative leaflet and asking questions about the clinical trial improves the informed consent procedure remains to be fully investigated.
Comment in
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Doing research on the ethics of doing research.Crit Care. 2007;11(1):111; discussion 111. doi: 10.1186/cc5684. Crit Care. 2007. PMID: 17316465 Free PMC article.
References
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- Word Medical Association Declaration of Helsinki: Ethical Principles for Medical Research involving Human Subjects 5th revision Edinburgh. 2000. - PubMed
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- OJ. L 121/34. 2000. Directive 2001/20/EC of the European Parliament and of the Council of the 4 April 2001 on the approximation of the laws, regulations and administrative provisions of the Member States relating to the implementation of good clinical practice in the conduct of clinical trials on the medicinal products for human use. 4 April 2001. - PubMed
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- National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research . The Belmont Report: Ethical Principles and Guidelines for the Protection of Human Subjects in Research. Washington, DC: US Government Printing Office; 1979. - PubMed
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