Cardiac Drugs Study

mycrofft

Still crazy but elsewhere
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Without informed and uncoerced consent from each patient to diverge from accepted (if maybe wrong) standards, this is a huge ethical breach and may actually be illegal.

If a list of cardiac patients, signed on ethically beforehand and likely to require such treatment, was used to determine who underwent this, then it would be ok.



http://www.cdc.gov/tuskegee/after.htm
 
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mycrofft

Still crazy but elsewhere
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usalsfyre

You have my stapler
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Without informed and uncoerced consent from each patient to diverge from accepted (if maybe wrong) standards, this is a huge ethical breach and may actually be illegal.

If a list of cardiac patients, signed on ethically beforehand and likely to require such treatment, was used to determine who underwent this, then it would be ok.



http://www.cdc.gov/tuskegee/after.htm

There are published guidelines for research without consent, so it's not as huge of a breach as made out to be.

Comparing a trial with the goal of comparing cardiac drugs to placebo
 

Bullets

Forum Knucklehead
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Every time a study is proposed, people claim that not applying current treatment x would be an ethical violation.

Why? How is it an ethical violation to not administer medication that we are beginning to believe may not provide any benefit and might actually cause harm? Is it not an ethical violation to administer a drug that causes BraIn damage? To provide a treatment that may cause increased brain pressure? If there is not proof it works how is not using it unethical?

Is it unethical that we don't carry leeches and bleed patients?
 

Christopher

Forum Deputy Chief
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Anyone else working for an agency that is apart of this study? What are your thoughts? Any ethical concerns regarding patients having to choose to not be apart of the study?

http://www.oregonlive.com/health/index.ssf/2012/07/emergency_care_study_in_portla.html

Fun fact: there are no large, well designed studies which prove that the "standard of care" in cardiac arrest benefits patients.

Fun fact: there are no large, well designed studies which prove that the "standard of care" in cardiac arrest harms patients.

Fun fact: there are small studies, animal studies, prospective studies, retrospective studies, etc, which show improved survival with the "standard of care" in cardiac arrest patients.

Fun fact: there are small studies, animal studies, prospective studies, retrospective studies, etc, which show decreased survival with the "standard of care" in cardiac arrest patients.

The ethical concern is our continued usage of these therapies WITHOUT performing large, well designed studies.
 

JPINFV

Gadfly
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There are published guidelines for research without consent, so it's not as huge of a breach as made out to be.

Comparing a trial with the goal of comparing cardiac drugs to placebo


There's the ability to do population based consent when individual consent isn't possible, such as any large EMS study. There are ways to refuse to be a part of the study, normally by wearing a medic alert bracelet that clearly shows that the individual doesn't want to be a part of the study.
 

EpiEMS

Forum Deputy Chief
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There are no ethical concerns here. The known, effective procedures are being performed (CPR and defibrillation). Most else is plausible, but anecdotal.
 

webster44

Forum Crew Member
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Fun fact: there are no large, well designed studies which prove that the "standard of care" in cardiac arrest benefits patients.

Fun fact: there are no large, well designed studies which prove that the "standard of care" in cardiac arrest harms patients.

Fun fact: there are small studies, animal studies, prospective studies, retrospective studies, etc, which show improved survival with the "standard of care" in cardiac arrest patients.

Fun fact: there are small studies, animal studies, prospective studies, retrospective studies, etc, which show decreased survival with the "standard of care" in cardiac arrest patients.

The ethical concern is our continued usage of these therapies WITHOUT performing large, well designed studies.

+1

the ethical problem to me is that we are giving medications that have not been rigorously studied. and the studies that do exist don't show any improved neurological outcome.
 

Bullets

Forum Knucklehead
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+1

the ethical problem to me is that we are giving medications that have not been rigorously studied. and the studies that do exist don't show any improved neurological outcome.

(insert dripping sarcasm)

But ROSC!
 
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