Refining the Enrolment Process in Emergency Medicine Research

ORIGINAL RESEARCH, April 2016, VOL IV ISSUE I, ISSN 2042-4884
10.5083/ejcm.20424884.147 , Cite or Link Using DOI
Creating a Digital Object Identifier Link

A digital object identifier (DOI) can be used to cite and link to electronic documents. A DOI is guaranteed never to change, so you can use it to link permanently to electronic documents.

To find a document using a DOI

  1. Copy the DOI of the document you want to open.
    The correct format for citing a DOI is as follows: doi:10.1016/S0140-6736(08)61345-8
  2. Open the following DOI site in your browser:
    dx.doi.org
  3. Enter the entire DOI citation in the text box provided, and then click Go.
    The document that matches the DOI citation will display in your browser window.

The DOI scheme is administered by the International DOI Foundation. Many of the world's leading publishers have come together to build a DOI-based document linking scheme known as CrossRef.

Kate M Sahan, Keith M Channon, Robin P Choudhury, Rajesh K Kharbanda, Regent Lee, Mark Sheehan

Research in the emergency setting involving patients with acute clinical conditions is needed if there are to be advances in diagnosis and treatment. But research in these areas poses ethical and practical challenges. One of these is the general inability to obtain informed consent due to the patient’s lack of mental capacity and insufficient time to contact legal representatives.

Regulatory frameworks which allow this research to proceed with a consent ‘waiver’, provided patients lack mental capacity, miss important ethical subtleties. One of these is the varying nature of mental capacity among emergency medicine patients. Not only is their capacity variable and often unclear, but some patients are also likely to be able to engage with the researcher and the context to varying degrees. In this paper we describe the key elements of a novel enrolment process for emergency medicine research that refines the consent waiver and fully engages with the ethical rationale for consent and, in this context, its waiver. The process is verbal but independently documented during the ‘emergent’ stages of the research. It provides appropriate engagement with the patient, is context-sensitive and better addresses ethical subtleties. In line with regulation, full written consent for on-going participation in the research is obtained once the emergency is passed.