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

Kayte Spector-Bagdady, Holly Fernandez Lynch, Barbara E. Bierer, Luke Gelinas, Sara Chandros Hull, David Magnus, Michelle N. Meyer, Richard R. Sharp, Jeremy Sugarman, Benjamin S. Wilfond, Ruqaiijah Yearby, Seema Mohapatra

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish (US)
Pages (from-to)51-58
Number of pages8
JournalHastings Center Report
Volume52
Issue number1
DOIs
StatePublished - Jan 1 2022

Keywords

  • clinical trials
  • Covid-19
  • public health
  • research ethics
  • trial recruitment

ASJC Scopus subject areas

  • Health(social science)
  • Issues, ethics and legal aspects
  • Philosophy
  • Health Policy

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