The ethics of war-time data in paediatric trauma: attitudes, angles and impacts

• Published in: BMJ global health Vol. 7; no. Suppl 8; p. e013071
• Main Authors: Taghavi, Kiarash, Isaacs, David, McLeod, Liz, Gillett, Grant, Brasher, Christopher
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd 01.10.2023; BMJ Publishing Group LTD; BMJ Publishing Group
• Subjects: Casualties; Child health; Commentary; Consent; Consortia; Ethics; Medical research; Morality; Paediatrics; Pediatrics; Researchers; Review boards; Sociopolitical factors; Surgery; Trauma; Traumatology; War crimes; World War II; United States > US; Afghanistan; Iraq
• ISSN: 2059-7908; 2059-7908
• DOI: 10.1136/bmjgh-2023-013071

Correspondence to Dr Kiarash Taghavi; kiarash.taghavi@gmail.com Summary box Research conducted on vulnerable populations is only justified if it is responsive to the health needs or priorities of the vulnerable population, and this population should stand to benefit from the knowledge, practices or interventions that result from the research. Ethics statement: the following statement is included in the methods: ‘This study was initiated under a protocol reviewed and approved by the San Antonio Military Medical Center Institutional Review Board’. Impact of publication: this study has been central to the paediatric trauma and massive transfusion literature.7 It largely justifies the threshold for more invasive intervention after a resuscitative threshold is met in injured children (over 40 mL/kg within the first 24 hours was associated with excess in-hospital mortality). Recruitment or use of children under the age of 15 is defined as a war crime by the International Criminal Court. [...]given the median age in this study, the great majority of these children were either civilian casualties, or involved in a war through inhumane or criminal channels.10 Medicine has had a compromised moral record when it comes to human experimentation, with the most glaringly obvious and well-known example being Nazi experimentation on concentration camp victims.11 12 For the purpose of medical research, any research population deprived of ‘basic rights’ should be recognised as a vulnerable population.