Legislation hampers medical research in acute situations

Jakob Hartvig Thomsen, Christian Hassager, John Bro-Jeppesen, Lars Køber, Søren Boesgaard, Jacob Eifer Møller, Niklas Nielsen, Michael Wanscher, Jesper Kjærgaard

1 Citationer (Scopus)

Abstract

Introduction: Informed consent in incapacitated adults is permitted in the form of proxy consent by both the patients’ closest relative (next of kin, NOK) and general practitioner (GP). In research in acute situations not involving pharmaceuticals, Danish legislation allows for randomisation and subsequent proxy consent, as soon as possible. The aim of this study was to describe the delay associated with obtaining consent and to assess whether consent from NOK or GP/Danish Health and Medicines Authority is obtained with delays beyond the intervention. Methods: In a prospective study, 171 comatose out-ofhospital cardiac arrest (OHCA) patients were randomised to targeted temperature management. Patients were randomised before NOK could be informed, and proxy consent was obtained as soon as possible. Written consent from NOK and GP were our study data. Results: We obtained all legally required consent: 169 cases of consent were obtained from NOK, two patients gave consent before NOK, in no cases was consent denied by the proxy. Consent from NOK was obtained with a median delay of zero days (interquartile range (IQR): 0-1, max. 128 days). Delay from NOK consent to GP consent was a median nine days (IQR: 6-23, max. 527 days). Conclusion: NOK fully accepted participation in a clinical trial after OHCA with short delays in consent. Consent from GPs was associated with long delays beyond the intervention, which make GPs less appropriate for proxy consent of incapacitated adults in acute situations. The Ethics Committees’ approval of the trial justified by their competence and authority, combined with the NOK´s insight into the patient’s wishes may be a relevant and feasible alternative to the current consent procedure. Funding: This work was supported by the European Regional Development Fund through the Interreg IV A OKS programme (NYPS ID: 167157) with regards to authors JHT, CH, NN and JK. Trial registration: not relevant.

OriginalsprogEngelsk
ArtikelnummerA5037
TidsskriftDanish Medical Journal
Vol/bind62
Udgave nummer3
Sider (fra-til)1-5
Antal sider5
ISSN2245-1919
StatusUdgivet - mar. 2015

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