Medicina Intensiva  (English Edition) Medicina Intensiva  (English Edition)
Series in Intensive Medicine: Methodological update in Medicina Intensiva
Ethics research in critically ill patients
Ética de la investigación en el paciente crítico
A. Estella
Unidad de Gestión clínica de Medicina Intensiva, Hospital del SAS de Jerez, Jerez, Spain
Received 18 July 2017, Accepted 05 November 2017

Research in critical care patients is an ethical obligation. The ethical conflicts of intensive care research arise from patient vulnerability, since during ICU admission these individuals sometimes lose all or part of their decision making capacity and autonomy. We therefore must dedicate effort to ensure that neither treatment (sedation or mechanical ventilation) nor the disease itself can affect the right to individual freedom of the participants in research, improving the conditions under which informed consent must be obtained. Fragility, understood as a decrease in the capacity to tolerate adverse effects derived from research must be taken into account in selecting the participants. Research should be relevant, not possible to carry out in non-critical patients, and a priori should offer potential benefits that outweigh the risks that must be known and assumable, based on principles of responsibility.


La investigación en el enfermo crítico es una obligación ética. Los conflictos éticos de la investigación en medicina intensiva provienen de la vulnerabilidad del enfermo, que en ocasiones ha perdido o visto reducida su capacidad de decidir, perdiendo así su autonomía. Debemos por tanto aunar esfuerzos para que ni los tratamientos, como la sedación o la ventilación mecánica, ni la propia enfermedad cercenen el derecho a la libertad individual de los participantes en la investigación, favoreciendo las condiciones en que hemos de recabar el consentimiento informado. La fragilidad, entendida como el compromiso de la capacidad para tolerar efectos adversos derivados de la investigación, ha de ser tenida en cuenta en la selección de los participantes. Esta ha de ser pertinente, imposible de aplicar en pacientes menos graves y ofrecer a priori unos beneficios potenciales que superen unos riesgos que han de ser conocidos y asumibles en función de una ética de la responsabilidad.

Bioethics, Research, Critically ill patient, Inform consent
Palabras clave
Bioética, Investigación, Paciente crítico, Consentimiento informado


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