Informed consent for therapy and research in continuous renal replacement therapy: An international survey

Objective: To study the approach of health care workers (HCW) to informed consent for therapy and research in the field of continuous renal replacement therapy (CRRT) Design: Administration of questionnaire. Setting: Two International Courses on Critical Care Nephrology (CN) held in Vicenza and Melbourne. Participants: Eight hundred and twenty one course participants. Results: We obtained 349 analysable questionnaires (42.5% of participants). Only 22.5% of responders always obtain informed consent for CRRT; 70.3% just inform patients/relatives without seeking consent, 7.1% never obtain informed consent. In ICU patients, informed consent is considered "good, correct and feasible" for therapy and for research by only 13% and 27% of responders, respectively. Consent for clinical research obtained from the next of kin or legal guardian is considered "good, correct and feasible" by 56.3% of respondents, while 39.1% believe that next of kin or legal guardians can not really make informed decisions. Finally, nearly half of responders think that present rules hamper research in ICU. For many questions, significant variability of responses was found according to profession, speciality and origin of responders. Conclusions: In the field of CRRT, stated practice, beliefs and currently accepted ethical standards vary greatly according to profession, speciality and origin. A significant disagreement between what is widely promoted to be the "correct" approach and what is currently done is evident.