Hospitals and ethics committees
In many hospitals, the processes that are normally in place for
experimental treatments were disrupted by the pandemic. Ethics
committees did not meet, there was no one to prepare and file proposals
anyway. As a result, patients got treated with an experimental (albeit
“old and known”) drug without proper informed consent, without ethics
approval.
Clinical pharmacologists serving on these committees should take lead in
preparing proper procedures for emergency authorisation with an informed
consent that can be updated as more information becomes available. The
framework needs to be prepared in advance with clear roles and
responsibilities, since at a time of crisis it is perhaps not reasonable
to expect intensive care physicians to deal with the paperwork required.
Clinical pharmacologists seem to be the logical choice for leading this
process and assisting clinicians in this context.