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BMJ No 7102 Volume 315 Letters Saturday 26 July 1997 Informed consentResearch studies in diving medicine are considered by Ministry of Defence research ethics committeeEditor,In his letter Peter Wilmshurst made some general comments on the use of human volunteers for medical research; however, he singled out his concern about the adequacy of the ethical control of research in diving medicine, most of which, he asserts, 'is performed outside hospitals and without the safeguard of hospital ethics committees.'(1) Diving medicine is a highly specialised branch of medicine covering basic physiological, operational, and commercial aspects of the subject. It is appropriate, therefore, that ethical considerations of non-clinical research in diving medicine should be dealt with by committees that are independent of hospital ethics committees but nevertheless conform with the codes of practice outlined by the Royal College of Physicians.(2) Examples are the procedures that are adopted by the Ministry of Defence at its two experimental diving establishments: DERA (Defence Evaluation and Research Agency) Alverstoke and the Institute of Naval Medicine at Alverstoke, where non-clinical aspects of diving are dealt with. Each research project is first scrutinised from the scientific and ethical points of view by local advisory committees. It is then considered by the Ministry of Defence (navy) personnel research ethics committee for final assessment. The membership of this committee is constituted according to the guidelines recommended by the Royal College of Physicians(2) and consists of nine civilian personnel, all but one being independent of the Ministry of Defence. In addition, Royal Navy personnel and others with a specialist knowledge of diving medicine are coopted. The volunteers are drawn from Royal Navy or Ministry of Defence personnel, and there is no question of their services being obtained by coercion. Before being invited to sign the consent form they receive in writing a description of the project and an account of their proposed participation in it, the methods to be used, the benefits likely to accrue from the project and any possible risks to their own health. They are given the opportunity of discussing the project with the project officer and independent medical officer, and it is emphasised to them that they can withdraw from the project at any time, either before it starts or during it, without having to give a reason why. Their decision does not entail any loss of earnings or seniority and does not affect their prospects of promotion. All volunteers are examined for medical fitness by the independent medical officer. I hope that these details will help to allay any fears that ethical aspects of the use of human volunteers in naval diving medicine in Britain have not been properly addressed. M de Burgh Daly
Department of Physiology,
References 1 Wilmshurst P. Informed consent in medical research. BMJ 1997;314:1481. (17 May.) 2 Royal College of Physicians of London. Guidelines on the practice of ethics committees in medical research involving human subjects. 3rd ed. London: RCP, 1996.
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