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High-Dose Epinephrine in Cardiopulmonary Resuscitation

Darell E. Heiselman, DO
JAMA. 1993;269(11):1383. doi:10.1001/jama.1993.03500110051021.
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To the Editor.  —Callaham et al1 state in their "Methods" section that informed consent was not obtained but was "implied on a compassionate basis." I can understand the need to enroll patients without consent into such a study because of the urgency of the clinical setting. In addition, the incurred delay in attempting to obtain informed consent from surrogate decision makers would make conclusions and effects of treatment impossible to interpret. Recently, there have been a multitude of reports involving resuscitation research using high-dose epinephrine.2,3 Before we begin down this slippery slope, we as researchers in cardiopulmonary resuscitation must ensure that if there is to be no informed consent, ethically there at least must be disclosure of the research performed. My concern is that investigators in trials such as the one reported make no statements or assurances that truthful, full disclosure was performed, especially to the families of


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