Subjecting infants to low oxygen concentrations seems unethical

EDITOR—The ethics of Parkins et al's study depend partly on whether there is any potential benefit to the infants from the experiment.1 If parents subject their infant to low oxygen concentrations in an aeroplane they take a risk which is balanced against the benefit of air travel. Unless there is some real prospect of identifying infants at risk and offering useful protection against the sudden infant death syndrome, it seems to me to be unethical to subject those infants to the risk of exposure to low oxygen concentration. The fact that some of the families had previously experinced the loss of a child may have increased the likelihood of compliance. This makes me even more worried about the ethics of the study.

Research should contain element of treatment

EDITOR—Parkins et al and Hughes, the chairman of the local ethics research committee, in their reply to the commentary by Savulescu, repeat that the parents knew of the potential risks and gave consent.1 This does not justify the research. In the case of proxy consent the people—in this case the parents—vested with that power must use it reasonably. The law regarding the participation of children in non-therapeutic research is unclear. The most favourable suggestion, from the researchers' point of view, is that the validity of consent should be based on whether the parents are clearly not acting against the best interests of the child. Thus the amount of risk that the child is exposed to becomes relevant.2

According to the British Paediatric Association it would be unethical to submit child subjects to more than minimal risk when the research offers no or minimal benefit to them.3 The Institute of Medical Ethics has defined minimal as a risk of death of less than 1:1 000 000, a risk of major complications of less than 1:100 …