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October 18, 1995

Informed Consent for Emergency Research-Reply

Author Affiliations

Hennepin County Medical Center Minneapolis, Minn
University of Washington Seattle
Harbor-UCLA Medical Center Los Angeles, Calif

JAMA. 1995;274(15):1196. doi:10.1001/jama.1995.03530150020016

In Reply.  —We appreciate the interest our consensus document has generated and welcome the opportunity to address the concerns of Drs Merz and Caplan. As these points illustrate, the problems surrounding informed consent in emergency research are complex.We agree that prior expressions of the desires of patients should be respected. In circumstances in which advance directives are known, these wishes must be followed and would exclude such patients from resuscitation research. However, in most emergency research circumstances, those desires are unknown. The inability to determine the patient's prior wishes, to identify and locate a legally authorized representative, and often even to establish the identity of the critically ill or injured patient all contribute to the difficulty of the problem.We also agree with the suggestion of Merz and Caplan that in some acute circumstances, it may be feasible to obtain prospective informed consent; our recommendations focus on those emergency

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