Clinical Ethics in Anesthesiology

Research on the management of pain and other symptoms is crucial to provide better care for acute, postoperative, and chronic symptoms, as well as better symptom management at the end of life. Some aspects do present difficulties more specific to the context of symptom management studies. These include difficulties related to scientific methodology, fair subject selection, obtaining a favorable risk/benefit ratio, and informed consent. Researchers always have the obligation to obtain informed consent from research subjects. Even with explicit patient consent, the researcher has the obligation to minimize risk and discomfort to the patient. Research involving symptomatic relief at the end of life is ethical, but requires special considerations. Particular attention to subject comfort and safety is important in placebo-controlled trials. Patient assessment of benefits and burdens may shift during the trial and require reconsideration.