To the Editor.—
The article entitled "Deferred Consent" by Abramson et al1 is both interesting and provocative; however, the authors slide over two very important points that are of major concern.The first of these two points touches on the distinction between experimental therapy and research and the standard of care the law assigns to both. The authors are quite right in stating that a physician may, under appropriate circumstances, consider and employ an experimental therapy that might benefit his patient in an otherwise hopeless situation. The obligations imposed here by law and by ethics as well are to be found within the constructs of a physician-patient relationship. This relationship is different in many respects from that of a researcher-subject relationship. The duties inherent therein shift as the concept of the relationship shifts. For example, the definition of research itself dismisses any immediate idea of a direct benefit to
Marsh FH. Consent: Informed, Implied, and Deferred. JAMA. 1986;256(14):1891. doi:10.1001/jama.1986.03380140061007
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