Voit Katja, Skuban-Eiseler Tobias, Orzechowski Marcin, Steger Florian
Institute of the History, Philosophy and Ethics of Medicine, Ulm University, 89081 Ulm, Germany.
kbo-Isar-Amper-Klinikum Region München, 85540 Haar, Germany.
Healthcare (Basel). 2023 Jun 17;11(12):1793. doi: 10.3390/healthcare11121793.
Health crises such as the current COVID-19 pandemic pose challenges to the conduct of clinical studies. Aspects of research ethics, such as obtaining informed consent (IC), can be complicated. We are concerned with whether or not the proper IC procedures were followed in the context of clinical studies at Ulm University in the years 2020 to 2022. We identified all protocols of clinical studies dealing with COVID-19 that the Research Ethics Committee of Ulm University has reviewed and voted on in the years 2020 to 2022. We then performed a thematic analysis regarding the following aspects: study type, handling of IC, type of patient information, means of communication, applied security precautions, and the approach to participants from vulnerable groups. We identified n = 98 studies that dealt with COVID-19. In n = 25 (25.51%), IC was obtained traditionally in written form, in n = 26 (26.53%) IC was waived, in n = 11 (11.22%) IC was obtained delayed, and in n = 19 (19.39%) IC was obtained by proxy. No study protocol was accepted that waived IC in case IC would have been required in times outside of pandemics. It is possible to obtain IC even in times of severe health crises. In the future, it is necessary to address in greater detail and with legal certainty which alternative methods of obtaining IC are possible and under which circumstances IC can be waived.
当前的新冠疫情等健康危机给临床研究的开展带来了挑战。研究伦理的各个方面,如获得知情同意(IC),可能会变得复杂。我们关注的是2020年至2022年期间乌尔姆大学临床研究中是否遵循了适当的知情同意程序。我们确定了乌尔姆大学研究伦理委员会在2020年至2022年期间审查并投票通过的所有涉及新冠疫情的临床研究方案。然后,我们针对以下方面进行了主题分析:研究类型、知情同意的处理、患者信息类型、沟通方式、应用的安全预防措施以及对弱势群体参与者的处理方法。我们确定了n = 98项涉及新冠疫情的研究。在n = 25项(25.51%)研究中,传统上以书面形式获得知情同意;在n = 26项(26.53%)研究中,知情同意被豁免;在n = 11项(11.22%)研究中,知情同意被延迟获得;在n = 19项(19.39%)研究中,知情同意通过代理人获得。没有一项研究方案在非疫情时期需要知情同意的情况下被接受豁免知情同意。即使在严重健康危机时期也有可能获得知情同意。未来,有必要更详细且在法律层面明确哪些替代方法可以获得知情同意,以及在何种情况下可以豁免知情同意。