Attitudes of patients and family members towards deferred and waived consent in ECPR research, an ancillary study of the INCEPTION trial

  • Stijn E.D.M. Eussen*
  • , Anina F. van de Koolwijk
  • , Thijs S.R. Delnoij
  • , Martje M. Suverein
  • , Brigitte Essers
  • , Renicus C. Hermanides
  • , Luuk Otterspoor
  • , Carlos V. Elzo Kraemer
  • , Joris J. van der Heijden
  • , Erik Scholten
  • , Corstiaan den Uil
  • , Dinis Dos Reis Mirada
  • , Sakir Akin
  • , Jesse de Metz
  • , Iwan van der Horst
  • , Bjorn Winkens
  • , Jos G. Maessen
  • , Roberto Lorusso
  • , Marcel C.G. van de Poll
  • , Martje M. Suverein
  • Thijs S.R. Delnoij, Roberto Lorusso, George J. Brandon Bravo, Luuk Otterspoor, Carlos V. Elzo Kraemer, Alexander P.J. Vlaar, Erik Scholten, Tim Jansen, Bas van den Bogaard, Marijn Kuijpers, Ka Yan Lam, José M. Montero Cabezas, Antoine H.G. Driessen, Saskia Z.H. Rittersma, Bram G. Heijnen, Dinis Dos Reis Miranda, Gabe Bleeker, Jesse de Metz, Renicus S. Hermanides, Jorge Lopez Matta, Susanne Eberl, Dirk W. Donker, Robert J. van Thiel, Sakir Akin, Oene van Meer, José Henriques, Karen C. Bokhoven, Henrik Endeman, Jeroen J.H. Bunge, Martine E. Bol, Bjorn Winkens, Brigitte Essers, Patrick W. Weerwind, Jos G. Maessen
*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Background In emergency settings, obtaining timely informed consent is not always feasible, making deferred and waived consent a potential solution. Despite its frequent use in high-risk research, the experiences and opinions of patients and (bereaved) relatives have been scarcely investigated. This study examined their attitudes towards enrolment in the INCEPTION-trial (NCT03101787) on extracorporeal cardiopulmonary resuscitation (ECPR). Methods Questionnaires were sent to survivors and (bereaved) relatives who had signed consent forms for follow-up research in the initial INCEPTION-trial. Additionally, relatives where consent was waived were contacted through their general practitioner with a request to participate. Responses included Likert-scale and free-text data, were analysed using descriptive statistics and non-parametric tests. Results A total of 32 of 38 (overall response rate 84.2%) sent questionnaires were returned, from 9 survivors, 9 corresponding relatives of these survivors, 6 relatives of non-survivors who provided proxy consent and 8 relatives of non-survivors whose consent was waived. 81.3% of the respondents (strongly) supported alternative consent procedures. No statistically significant differences were found between survivors and non-survivors or ECPR versus conventional cardiopulmonary resuscitation (CCPR). The need for, and challenges of research in an emergency setting were acknowledged. Aftercare contact improved understanding of the trial and helped in bereavement processing. Conclusions Overall, patients and (bereaved) relatives had a positive attitude towards waived and deferred consent procedures in high-risk, high-mortality research in the emergency setting. Information provision at a later stage, once the emotional burden has eased, is appreciated.

Original languageEnglish
Article number101239
JournalResuscitation Plus
Volume28
DOIs
Publication statusPublished - Mar 2026

Keywords

  • Ethics
  • Extracorporeal cardiopulmonary resuscitation
  • Informed consent
  • Out-of-hospital cardiac arrest

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