From "CAN HYPOTHERMIA SAVE GUNSHOT VICTIMS?/A new procedure freezes trauma patients who are bleeding out in order to buy time to operate."
Experiments have been done with dogs and pigs, but how do you ethically try this on a person? Will the ethicists waive the usual consent requirements?
Prospective patients, being clinically dead, will be incapable of giving consent, and the speed of treatment—the decision to begin E.P.R. has to be made within a matter of seconds—precludes identifying, let alone contacting, the next of kin. (The F.D.A. requires informed consent for all human medical trials, but it does grant exceptions for emergency research.)There's a whole racial angle to that question, as the idea is to test this at the University of Maryland’s R Adams Cowley Shock Trauma Center in Baltimore:
Of the more than nine hundred people who were shot in the city last year—three hundred of whom died—more than ninety per cent were male, more than ninety per cent were black, and most were under the age of thirty.... Because of the consent issue, an institutional review board at the University of Maryland required [surgery professor Sam] Tisherman to devise a way for people to elect not to be enrolled in advance. He designed a red rubber bracelet.... Anyone wanting to opt out could request one and wear it at all times....You have to wear a bracelet all the time to say no? Why not make the bracelet mean yes? At one "community-consultation" one man said: "We’re guinea pigs—your body language says it!"
Tisherman winced. The man’s point was essentially unanswerable. African-Americans have indeed been used as guinea pigs, the unwitting victims of full-body radiation or unnecessary surgeries conducted in the name of research. The Tuskegee syphilis experiment, in which lifesaving treatment was withheld from black men for forty years so that scientists could study the disease, is merely the most infamous example. As a result, mistrust of the medical establishment has long been widespread among African-Americans. In 1982, Clive Callender, a surgeon at Howard University, published a study showing that many African-Americans feared that surgeons might actually withhold advanced resuscitation measures from black patients in order to harvest their organs for sick white people.