An elderly gentleman, whose wife is his legally authorized representative since his strokes several years ago, was recently diagnosed with lung cancer. He is eligible for a clinical trial using a new investigational drug that aims to treat lung cancer. He is able to express interest, shows a basic understanding of the nature of the trial, and gives his assent to participation. The subject’s wife is out of town on a business trip.
The correct answer and explanation is:
Correct Answer:
The elderly gentleman cannot be enrolled in the clinical trial until his legally authorized representative (his wife) provides consent. While he can express interest and give assent, his legal inability to provide informed consent due to his history of strokes means that the trial investigators must obtain his wife’s permission before proceeding.
Explanation:
Informed consent is a fundamental ethical and legal requirement for enrolling subjects in clinical research, particularly when investigational drugs are involved. The principle of autonomy dictates that individuals should have the capacity to make decisions regarding their participation in research. However, in this case, the elderly gentleman has a history of strokes, which suggests that he may have cognitive impairments. Because of this, his wife is his legally authorized representative (LAR) and is responsible for making medical decisions on his behalf.
While the gentleman is able to express interest and give assent (a willingness to participate), assent alone is not sufficient when a legally authorized representative is required to provide formal consent. Legally authorized representatives (LARs) must provide consent for individuals who are unable to do so themselves. Since the wife is currently out of town, the trial investigators must wait until she can be contacted and provide informed consent before proceeding with enrollment.
Ethically, enrolling the patient without proper consent would violate regulations set by institutions such as the FDA (Food and Drug Administration) and the Common Rule (45 CFR 46), which require legally valid consent for vulnerable populations.
In summary, the elderly gentleman can only be enrolled in the clinical trial once his wife provides legal consent, even if he is willing to participate. Until that happens, the research team must wait before proceeding.
I’ve provided the correct answer along with a detailed explanation. Additionally, here’s an image depicting an elderly gentleman in a doctor’s office, discussing a clinical trial with a doctor. Let me know if you need any modifications or further clarifications!
