Abstract
To the Editor.—Abramson et al1 are to be congratulated for merging the legal doctrines of informed consent with the medical realities of research in the critically ill patient. They have thereby formulated a practical solution to a difficult problem. The institutional review boards (IRBs) of the various hospitals in the study should also be commended for their acceptance of this sorely needed concept.The authors have noted federal regulations that foster research and at the same time protect individuals. Unfortunately, despite these guidelines many IRBs and attorneys are reluctant to allow research to occur without the actual consent of the patient himself. Some people view research as a risk rather than as a benefit for subjects, especially if the subject has a 50% chance of receiving a placebo. Often forgotten is the Hawthorne effect-the fact that one may benefit solely by being part of a research project.2
