Human Lab Rats? U.S. Medical Study May Push Ethical Envelope

April 27, 2007 — -- New research involving the federal government is raising the medical and ethical question of when, if ever, experimental treatments should be performed on patients who have not given their consent.

The treatments are to involve severely injured trauma patients, who often are unconscious, near death and unable to give their consent to be part of an experiment.

Every year, tens of thousands of Americans are severely injured in traffic accidents, shootings and other emergencies. For decades, emergency workers have been using the same techniques to try to revive them.

Now, some doctors say it's time to test new methods.

"This research is critical because there's potential to save more lives," said Dr. Raul Coimbra, head of trauma medicine at the University of California-San Diego Medical Center, which is participating in the study.

As first reported in today's Washington Post, the researchers want to try new methods of stabilizing blood pressure and restarting hearts on some patients to see if they save more lives.

The federal government is on board, undertaking a $50 million research project involving more than 20,000 patients.

But some ethicists say it is never acceptable to test new treatments without a patient's permission.

"These people aren't getting a choice," said Dr. George Annas of Boston University. "People aren't being told this is an experiment. People aren't being given the right not to be experimented on."

Supporters of the experiment say it's often impossible to get permission in such cases.

"Imagine yourself involved in a motor vehicle accident or in multiple gunshot wounds and you're bleeding to death," Coimbra said. "How can one obtain informed consent in those circumstances? There are usually no family members around, and we have to make a decision in a split second to save your life."

Trauma is the biggest killer of Americans under age 44. Most patients who receive the current treatments do not survive. Coimbra and others say it is unethical not to try to save more of them.