Combat casualty care research and informed consent

Combat casualty care research on far-forward resuscitation is necessary for optimizing the future care of the wounded soldier. Present legal directives pertaining to the use of humans as subjects in Department of Defense (DOD)-funded research require that prior informed consent from the subjects or their legal representatives be obtained. Application of these legal directives to present and future combat casualty care research will ultimately obstruct significant progress toward optimizing the care of the injured soldier. This article reviews the medical considerations surrounding resuscitation research that make obtaining traditional informed consent impossible, the present legal directives pertaining to DOD-funded research and informed consent, and the ethical issues that influence the conduct of human research. The necessary changes required to continue resuscitation research without informed consent, while still safeguarding the welfare of the patient, are suggested.