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Patients asked to consent to experimental brain injury treatment

The public in Tennessee and the rest of the country are becoming more aware of the dangers of traumatic brain injury, largely thanks to a growing national discussion about traumatic brain injury in sports. The medical community has been studying brain injuries for generations, but these conditions are still exceedingly difficult to treat. The fact is that the brain doesn't heal the way other parts of the body do, and so these injuries often lead to long-term or permanent disability.

One factor holding back research on treatment for brain injury is the issue of informed consent. Patients in Tennessee generally must give their informed consent before doctors may conduct experimental treatments on them. This means the doctor must explain the procedure and its potential risks and the patient must agree before the doctor can proceed. However, if the patient has suffered a serious head injury that could cause a brain injury, the patient may be too incapacitated to consent. As a result, many researchers can't experiment with techniques they'd like to try.

In a new study, researchers want to test if the female hormone progesterone can minimize the damage caused by brain swelling. However, they believe the treatment will work best if administered soon after the injury. Of course, soon after a head injury patients are often unconscious, or even in a coma, and so they cannot consent. And so, researchers are asking people at high risk of head injury, such as athletes and arborists, to effectively opt out of the requirement for informed consent. It could be that the people signing up for the program never actually receive the injuries or the treatment but if they are injured and receive the treatment, it could lead to valuable research -- perhaps even a better result for the patients themselves.

One can only hope that this study or others like it will one day lead to a breakthrough in treating brain injuries. Until that day comes, Tennessee residents who have suffered traumatic brain injury are left with extreme medical expenses, long-term rehabilitation costs, lost wages and other damages. When these damages are the result of an injury caused by someone else's negligence, the family may be compensated through a personal injury lawsuit.

Source: Providence Journal, "Brain injury study tries to balance ethics, research," Felice J. Freyer, Aug.3, 2013

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