Deferred consent in emergency care research: A comparative perspective of South African regulations

Obtaining informed consent from potential research participants can be fraught with difficulty at the best of times. In emergency care research, consent procedures are particularly controversial as research subjects are usually unable to voice their wishes and unable to consider the material benefits and risks of the medical procedures, treatment and research. And, an added level of difficulty is the unique nature of the emergency situation, where time is of the essence and obtaining proxy consent from a legal representative or family member is not always logistically possible. This article will consider the deferred consent procedures and regulations of emergency care research in South Africa. A comparative overview will then be provided of the relevant procedures and regulations on emergency care research in the UK, continental Europe, and the USA. The important oversight role of Research Ethics Committees and Institutional Review Boards in emergency care research will be emphasized in terms of the difficult ethical and legal concerns that must guide them in their decision-making responsibilities.