Philosophical, ethical, and legal aspects of resuscitation medicine. I. Deferred consent and justification of resuscitation research.
Philosophical, ethical, and legal aspects of resuscitation medicine. I. Deferred consent and justification of resuscitation research.
复制标题
复苏医学的哲学、伦理和法律方面。
作者：
B. Miller
临床复苏研究的知情前瞻性同意可能是不可能的。延迟同意是一个站不住脚的想法。同意继续研究不能用来支持曾经或本来同意开始研究的主张。未经知情同意而进行复苏研究的合理性条件是： a) 患者处于昏迷状态； b) 必须立即给予救生治疗； c) 鉴于所有可用的证据，有理由相信实验或对照治疗的死亡或严重缺陷的概率不大于常规治疗的死亡或严重缺陷的概率； d) 考虑到所有可用的证据，有理由相信实验或对照治疗取得正常或接近正常结果的可能性比常规治疗更大； e) 该研究可以提供证据，证明实验疗法和对照疗法之间在正常或接近正常生存率方面是否存在显着差异。
Informed prospective consent for clinical resuscitation research may not be possible. Deferred consent is an untenable notion. Consent to continue in research cannot be used to support a claim that there was, or would have been, consent to the initiation of research. The conditions for the justifiability of resuscitation research without informed consent are: a) patient is comatose; b) lifesaving treatment must be given immediately; c) given all available evidence, there is reason to believe that the probability of death or severe deficit with experimental or control therapy is not greater than the probability of death or severe deficit on usual therapy; d) given all available evidence, there is reason to believe that the probability of normal or near-normal outcome is greater on experimental or control therapy than on usual therapy; and e) the study can provide evidence on whether there is a significant difference between experimental and control therapies in the incidence of normal or near-normal survival.