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.