Allocation of Opportunities to Participate in Clinical Trials during the Covid‐19 Pandemic and Other Public Health Emergencies

Covid‐19 raised many novel ethical issues including regarding the allocation of opportunities to participate in clinical trials during a public health emergency. In this article, we explore how hospitals that have a scarcity of trial opportunities, either overall or in a specific trial, can equitabl...

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Bibliographic Details
Published in:Hastings Center Report 2022-01, Vol.52 (1), p.51-58
Main Authors: Spector‐Bagdady, Kayte, Lynch, Holly Fernandez, Bierer, Barbara E., Gelinas, Luke, Hull, Sara Chandros, Magnus, David, Meyer, Michelle N., Sharp, Richard R., Sugarman, Jeremy, Wilfond, Benjamin S., Yearby, Ruqaiijah, Mohapatra, Seema
Format: Article
Language:English
Subjects:
Clinical trials
Clinical Trials as Topic
COVID-19
Emergencies
Humans
Medical ethics
Pandemics
Pandemics - prevention & control
Patient Selection
Public Health
Research ethics
trial recruitment
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Summary:Covid‐19 raised many novel ethical issues including regarding the allocation of opportunities to participate in clinical trials during a public health emergency. In this article, we explore how hospitals that have a scarcity of trial opportunities, either overall or in a specific trial, can equitably allocate those opportunities in the context of an urgent medical need with limited therapeutic interventions. We assess the three main approaches to allocating trial opportunities discussed in the literature: patient choice, physician referral, and randomization/lottery. As, we argue, none of the three typical approaches are ethically ideal for allocating trial opportunities in the pandemic context, many hospitals have instead implemented hybrid solutions. We offer practical guidance to support those continuing to face these challenges, and we analyze options for the future.
ISSN:0093-0334
1552-146X
DOI:10.1002/hast.1297