Meeting unique requirements: Community consultation and public disclosure for research in emergency setting using exception from informed consent

Acad Emerg Med. 2021 Oct;28(10):1183-1194. doi: 10.1111/acem.14264. Epub 2021 May 26.

Abstract

Background: Exception from informed consent (EFIC) regulations for research in emergency settings contain unique requirements for community consultation and public disclosure. These requirements address ethical challenges intrinsic to this research context. Multiple approaches have evolved to accomplish these activities that may reflect and advance different aims. This scoping review was designed to identify areas of consensus and lingering uncertainty in the literature.

Methods: Scoping review methodology was used. Conceptual and empirical literature related to community consultation and public disclosure for EFIC research was included and identified through a structured search using Embase, HEIN Online, PubMed, and Web of Science. Data were extracted using a standardized tool with domains for major literature categories.

Results: Among 84 manuscripts, major domains included conceptual or policy issues, reports of community consultation processes and results, and reports of public disclosure processes and results. Areas of consensus related to community consultation included the need for a two-way exchange of information and use of multiple methods. Public acceptance of personal EFIC enrollment is commonly 64% to 85%. There is less consensus regarding how to assess attitudes, what "communities" to prioritize, and how to determine adequacy for individual projects. Core goals of public disclosure are less well developed; no metrics exist for assessing adequacy.

Conclusions: Multiple methods are used to meet community consultation and public disclosure requirements. There remain no settled norms for assessing adequacy of public disclosure, and there is lingering debate about needed breadth and depth of community consultation.

Keywords: clinical trials as topic; community-institutional relations; critical care; disclosure; emergencies; informed consent.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Disclosure*
  • Emergencies
  • Emergency Service, Hospital
  • Humans
  • Informed Consent*
  • Referral and Consultation