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(Stroke. 1998;29:1725-1729.)
© 1998 American Heart Association, Inc.

Comments, Opinions, and Reviews

Ethical Challenges in Stroke Research

Howard Slyter, MD

From The Permanente Medical Group, Kaiser Foundation Hospital, Sacramento, Calif.

Correspondence to Howard Slyter, MD, The Permanente Medical Group, Kaiser Foundation Hospital, 2025 Morse Ave, Sacramento, CA 95825. E-mail Howard.Slyter{at}NCAL.KAIPERM.ORG

Background—Ethical issues are a critical consideration in the design and conduct of clinical research.

Summary of Review—A number of completed trials of proposed stroke treatments raise classical ethical issues in challenging ways. The combination of acutely ill and vulnerable patients, the use of potentially toxic drugs, and very short time frames for decision making and drug administration demand an especially careful evaluation of risk and benefit, the process of consent, and the permissible treatment of control patients.

Conclusions—The study of acute stroke treatments may require more complex safeguards than other neuroclinical trials.

Key Words: clinical trials • ethics, medical • informed consent

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