The University of Pittsburgh Medical Center, along with other medical institutions, are beginning a clinical trial with emergency room patients who arrive with severe trauma injuries. The experimental procedure will drain the patient's blood and replace it with freezing salt water; this is known as E.P.R., or "emergency preservation and resuscitation." This procedure allegedly provides surgeons with extra time to provide life-saving surgery by essentially making the patient die, with the ability to resuscitate them by returning their own blood back into their system after the necessary surgery is performed. This procedure has only been tested on animals up to this point, so it is controversial and risky. The key factor making this so controversial is that the patients who will receive EPR, or rather those who will need to undergo this procedure, will be in such a severe condition that they will be unable to give informed consent for the doctor to proceed. Informed consent is one of the basic ethical requirements for medical research, yet there are some exceptions to allow medical procedures to be performed absent consent under federal regulations. The conditions that must be met are as follows: 1) the situation must be an emergency, 2) the human subject is in a life-threatening situation and available treatments are unproven or unsatisfactory, 3) participation in the research will hypothetically provide a direct benefit to the subject, 4) the research could not practicably be carried out without the waiver, and 5) obtaining informed consent is not feasible because the subject is unable to give consent.
Patients who will be subject to this research will be victims of gun violence or stabbings who are in cardiac arrest. Researchers sought input from the local communities where the subjects would be drawn from to find out the general public's opinions on the research; however, these surveys do not adequately represent the segment of the population that will be affected and not enough information has been distributed throughout the community. This controversial procedure will continue to prompt discussions in and around the University of Pittsburgh Medical Center, and may spread further if the research proves to be successful.
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