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Emergency research in children: options for ethical recruitment

Joe Brierley1, Vic Larcher

  • 1Paediatric and Neonatal Intensive Care Unit, Great Ormond Street Hospital for Children NHS Trust, Great Ormond St, London, UK. brierj@gosh.nhs.uk

Journal of Medical Ethics
|February 25, 2011
PubMed

Insights

Children are often excluded from vital medical research due to ethical barriers in emergency situations. This paper examines alternative consent methods like proxy or deferred consent to improve pediatric emergency research.

Area of Science:

  • Pediatric Emergency Medicine
  • Clinical Research Ethics

Background:

  • Children are frequently excluded from clinical research, leading to a lack of evidence-based treatments, earning them the term 'therapeutic orphans'.
  • Conducting research in emergency settings poses unique ethical challenges, particularly regarding informed consent for vulnerable pediatric populations.
  • While UK organizations support pediatric research, balancing participant protection with research access remains critical.

Purpose of the Study:

  • To explore ethical justifications and practical utility of alternative consent methods in pediatric emergency research.
  • To address the challenge of obtaining informed consent in time-sensitive emergency situations.
  • To safeguard vulnerable children and their families while advancing pediatric critical care research.

Main Methods:

  • Literature review and ethical analysis of consent models.
  • Exploration of proxy consent, deferred consent, and retrospective consent.
  • Discussion of safeguarding measures for pediatric participants in emergency research.

Main Results:

  • Traditional informed consent is often not feasible in true pediatric emergencies.
  • Alternative consent models (proxy, deferred, retrospective) offer potential solutions.
  • These methods require careful ethical consideration to protect participants.

Conclusions:

  • Alternative consent strategies are necessary to improve evidence-based care for children in emergencies.
  • Ethical frameworks must adapt to facilitate crucial pediatric research while ensuring robust participant protection.
  • Further development and implementation of these consent models are vital for advancing pediatric emergency medicine.

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