Maningas P A
Mil Med. 1989 Feb;154(2):71-3.
Combat casualty care research on far-forward resuscitation is necessary for optimizing the future care of the wounded soldier. Present legal directives pertaining to the use of humans as subjects in Department of Defense (DOD)-funded research require that prior informed consent from the subjects or their legal representatives be obtained. Application of these legal directives to present and future combat casualty care research will ultimately obstruct significant progress toward optimizing the care of the injured soldier. This article reviews the medical considerations surrounding resuscitation research that make obtaining traditional informed consent impossible, the present legal directives pertaining to DOD-funded research and informed consent, and the ethical issues that influence the conduct of human research. The necessary changes required to continue resuscitation research without informed consent, while still safeguarding the welfare of the patient, are suggested.
开展关于前沿复苏的战斗伤员护理研究对于优化未来伤兵护理至关重要。目前国防部（DOD）资助的研究中有关将人类作为研究对象的法律指令要求获得受试者或其法定代表人的事先知情同意。将这些法律指令应用于当前和未来的战斗伤员护理研究最终将阻碍在优化伤兵护理方面取得重大进展。本文回顾了围绕复苏研究的医学考量因素，这些因素使得无法获得传统的知情同意；介绍了目前与国防部资助研究及知情同意相关的法律指令，以及影响人体研究开展的伦理问题。文中还提出了在未经知情同意的情况下继续进行复苏研究，同时仍保障患者福利所需的必要变革。
