Evidence map›Paper›PMID 40167889›Full record

ArticleTheoretical medicine and bioethics2025

The role of the enrolling clinician in emergency research conducted under an exception from informed consent.

Katherine Sahan, Ethan Cowan, Mark Sheehan

Abstract read
In one paragraph

Article in Theoretical medicine and bioethics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Katherine SahanThe Ethox Centre, Oxford Population Health, University of Oxford, Big Data Institute, Old Road Campus, Roosevelt Drive, Oxford, UK. kate.sahan@ethox.ox.ac.uk.ORCID 0000-0001-5948-5581
Ethan CowanIcahn School of Medicine at Mount Sinai, New York, USA.
Mark SheehanThe Ethox Centre, Oxford Population Health, University of Oxford, Big Data Institute, Old Road Campus, Roosevelt Drive, Oxford, UK.

Funding

Wellcome TrustWellcome Trust 203132/Z/16/Z
6 · The paper itself

Abstract

The Exception from Informed Consent (EFIC) permits patient enrolment into therapeutic emergency research where obtaining informed consent is challenging. Yet this fails to resolve a core ethical conflict in the research and has generated controversy. This is because existing justification and practice has relied on applying EFIC per study-a wholesale permission to enroll irrespective of circumstance-instead of per patient. Our novel justification for enrolment centers on applying EFIC per patient, which empowers the enrolling clinician to judge whether to enroll patients with an Exception. This contrasts with the idea that clinician judgment is surplus to the judgements already made by institutions in deciding the research may proceed. Instead, we show that enrolling clinician's judgment is ethically significant and should not be overlooked: attending to this strengthens the research ethically and reduces controversy. There should be a bigger role for the clinician in the research enrolment space.

Indexed as

Biomedical ResearchEmergency MedicineInformed ConsentPatient SelectionPhysician's RoleEthics, ResearchHumansJudgmentEFICEthical enrolmentInformed consentResearch ethicsTherapeutic emergency research

Identifiers

PMID40167889
PMCPMC12037652

What OpenQuestion holds

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LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.