Intensive Care Medicine

, Volume 33, Issue 5, pp 807–813

Ability of family members to predict patient's consent to critical care research

  • Magali Ciroldi
  • Alain Cariou
  • Christophe Adrie
  • Djilali Annane
  • Vincent Castelain
  • Yves Cohen
  • Arnaud Delahaye
  • Luc Marie Joly
  • Richard Galliot
  • Maité Garrouste-Orgeas
  • Laurent Papazian
  • Fabrice Michel
  • Nancy Kenstish Barnes
  • Benoit Schlemmer
  • Frédéric Pochard
  • Elie Azoulay
Original

Abstract

Objective

A European Union Directive provides for the designation of a surrogate who can consent to or refuse inclusion of an incapacitated patient in research studies. The accuracy with which surrogates consent to research on behalf of patients has not been evaluated in the intensive care unit (ICU).

Methods

A prospective multicenter study was conducted in ten ICUs of the French Famirea study group between July and October 2004. Two hypothetical studies were simultaneously submitted to the patient, surrogate, and physician at the time that the patient was discharged to a ward. One study involved minimal risk and the other greater-than-minimal risk to the patients.

Results

With the minimal risk study there was patient-surrogate discrepancy in 32% of cases and patient-physician discrepancy in 25%. Corresponding figures with the greater-than-minimal risk study were 42% and 46%. None of the collected variables differed significantly between cases with and without patient-surrogate discrepancy.

Conclusions

Family members designated to serve as surrogate decision makers may fail to accurately consent to research for critically ill patients in one-third to nearly one-half of cases.

Supplementary material

134_2007_582_MOESM1_ESM.doc (26 kb)
Electronic Supplementary Material (DOC 27K)

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Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • Magali Ciroldi
    • 1
    • 2
  • Alain Cariou
    • 1
    • 3
  • Christophe Adrie
    • 1
    • 4
  • Djilali Annane
    • 1
    • 5
  • Vincent Castelain
    • 1
    • 6
  • Yves Cohen
    • 1
    • 7
  • Arnaud Delahaye
    • 1
  • Luc Marie Joly
    • 1
  • Richard Galliot
    • 1
    • 10
  • Maité Garrouste-Orgeas
    • 1
    • 8
  • Laurent Papazian
    • 9
  • Fabrice Michel
    • 1
  • Nancy Kenstish Barnes
    • 1
    • 2
  • Benoit Schlemmer
    • 1
    • 2
  • Frédéric Pochard
    • 1
    • 2
  • Elie Azoulay
    • 1
    • 2
  1. 1.Medical Intensive Care Unit, AP-HPSaint-Louis Teaching Hospital, Paris 7 UniversityParisFrance
  2. 2.Medical Intensive Care Unit and Biostatistics DepartmentSaint-Louis Teaching HospitalParisFrance
  3. 3.Medical Intensive Care UnitCochin Teaching HospitalParisFrance
  4. 4.Medical-Surgical ICUDelafontain HospitalSaint-DenisFrance
  5. 5.Raymond Poincaré Teaching HospitalGarchesFrance
  6. 6.Strasbourg Teaching HospitalStrasbourgFrance
  7. 7.Avicenne Teaching HospitalBobignyFrance
  8. 8.Saint-Joseph HospitalParisFrance
  9. 9.Saint Marguerite Teaching HospitalMarseilleFrance
  10. 10.Pontoise HospitalPontoiseFrance

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