Military Medical Research and Experimentation

Abstract

Medicine is often unprepared for the physical and psychological wounds of modern war. Military medicine requires urgent research to treat traumatic brain injury, develop resuscitation techniques, upgrade surgical procedures, and acquire effective drugs. Retrospective, observational, and survey studies dominate the literature. However, clinically controlled experimental studies, the gold standard of medical research, are rare in military medicine. Stringent informed consent requirements to protect service members from coercion and undue influence make it difficult to enlist them for in-theater clinical studies. When a research subject is unconscious and his representative is unavailable to give consent, investigators can request waivers. But due to concerns about patient vulnerability, waivers are rarely granted to allow researchers to recruit injured soldiers in the field. Easing informed consent requirements to match those of civilian medical research, and intensifying efforts to recruit civilian research subjects during war will improve the prospects of clinical research.