Skip to main content
Journal of Medical Ethics logoLink to Journal of Medical Ethics
. 2005 Oct;31(10):608–611. doi: 10.1136/jme.2004.010488

Stroke patients' preferences and values about emergency research

C Blixen 1, G Agich 1
PMCID: PMC1734033  PMID: 16199606

Abstract

Background: In the USA, the Food and Drug Administration waiver of informed consent permits certain emergency research only if community consultation occurs. However, uncertainty exists regarding how to define the community(ies) or their representatives.

Objective: To collect data on the actual preferences and values of a group—those at risk for stroke—most directly affected by the waiver of informed consent for emergency research.

Design: Face to face focused interviews were conducted with 12 patients who were hospitalised with a stroke diagnosis in the previous year. The interviews were audiotaped and a transcript based method was used for their analysis.

Results: All 12 participants felt "that it was important that new treatments for stroke be developed", but they were initially confused about the distinction between "research for stroke" and "emergency research for stroke". However, after explanation, most (n = 10; 83%) expressed willingness to participate in the latter. In the absence of a surrogate to give informed consent in a stroke emergency situation, the majority (n = 11; 92%) said they would want the physician to "go ahead and enrol them in the trial".

Conclusions: This study is the first to identify the values and concerns of individuals most directly affected by stroke emergency research. Further interviews and focus groups are needed to develop and test a validated questionnaire on the preferences and values surrounding emergency research for stroke.

Full Text

The Full Text of this article is available as a PDF (57.0 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Amdur R., Bachir N., Stanton E. Selecting a surrogate to consent to medical research. IRB. 2000 Jul-Aug;22(4):7–11. [PubMed] [Google Scholar]
  2. Baren J. M., Anicetti J. P., Ledesma S., Biros M. H., Mahabee-Gittens M., Lewis R. J. An approach to community consultation prior to initiating an emergency research study incorporating a waiver of informed consent. Acad Emerg Med. 1999 Dec;6(12):1210–1215. doi: 10.1111/j.1553-2712.1999.tb00135.x. [DOI] [PubMed] [Google Scholar]
  3. Biros M. H., Fish S. S., Lewis R. J. Implementing the Food and Drug Administration's final rule for waiver of informed consent in certain emergency research circumstances. Acad Emerg Med. 1999 Dec;6(12):1272–1282. doi: 10.1111/j.1553-2712.1999.tb00144.x. [DOI] [PubMed] [Google Scholar]
  4. Brody B. A., Katz J., Dula A. In case of emergency: no need for consent. Hastings Cent Rep. 1997 Jan-Feb;27(1):7–12. [PubMed] [Google Scholar]
  5. Corbie-Smith Giselle, Thomas Stephen B., St George Diane Marie M. Distrust, race, and research. Arch Intern Med. 2002 Nov 25;162(21):2458–2463. doi: 10.1001/archinte.162.21.2458. [DOI] [PubMed] [Google Scholar]
  6. Fagerlin A., Ditto P. H., Danks J. H., Houts R. M., Smucker W. D. Projection in surrogate decisions about life-sustaining medical treatments. Health Psychol. 2001 May;20(3):166–175. [PubMed] [Google Scholar]
  7. Kremers M. S., Whisnant D. R., Lowder L. S., Gregg L. Initial experience using the Food and Drug administration guidelines for emergency research without consent. Ann Emerg Med. 1999 Feb;33(2):224–229. doi: 10.1016/s0196-0644(99)70399-9. [DOI] [PubMed] [Google Scholar]
  8. Lidz Charles W., Appelbaum Paul S., Grisso Thomas, Renaud Michelle. Therapeutic misconception and the appreciation of risks in clinical trials. Soc Sci Med. 2004 May;58(9):1689–1697. doi: 10.1016/S0277-9536(03)00338-1. [DOI] [PubMed] [Google Scholar]
  9. Shavers Vickie L., Lynch Charles F., Burmeister Leon F. Racial differences in factors that influence the willingness to participate in medical research studies. Ann Epidemiol. 2002 May;12(4):248–256. doi: 10.1016/s1047-2797(01)00265-4. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Medical Ethics are provided here courtesy of BMJ Publishing Group

RESOURCES