The ethics of consent in delirium studies

Detecting deficits of sustained visual attention in delirium

“…In particular, it is not possible to determine how well the EDTB tasks are able to discriminate between delirium and dementia across the full spectrum of severities (eg, mild delirium versus severe dementia). This issue reflects a more general ethical concern relating to research with cognitively impaired populations, in which both the need to protect the autonomy of vulnerable individuals and the need to preserve their rights to benefit from research advances must be considered 31. The fact that these tasks have now shown promising utility in detecting delirium in patients able to provide written consent, therefore, provides some justification to next examine their performance in more impaired patients, such as those able only to provide verbal assent.…”

Designing clinical trials for the treatment of delirium

“…This topic is covered in more detail in an accompanying article by Holt et al in this issue [14]. An obvious advantage of prophylaxis or preoperative studies is the ability to obtain patient consent prior to the delirium precipitant.…”

Informed Consent in Palliative Care Clinical Trials: Challenging but Possible

“…Delirium research that is unable to utilize a 'person responsible' consent results in participant populations that don't represent delirium patients as a whole and hence limit generalizability when translating into clinical practice. 44 A successful use of proxy consent was in an RCT using best evidence pharmacological management of delirium and comparing risperidone with haloperidol or placebo. 45 This study acknowledges delirium is potentially reversible and if testamentary capacity is regained, participant consent is actively sought before continued participation in the study.…”