As funding for medical care – especially for patients with government “insurance” – dries up throughout this country, are rural communities in the US going to be subject to the same fate?

This says a lot about the commenter and lack of response to his comment shows why there is such trouble hiring.

While people have the right not be involved in research if they don’t want to- consider this. Etomidate and midazolam are both acceptable medications to use for intubation. Any doctor could choose to use either one for an intubation and not be faulted for it. Now all the study adds is an element of randomization and follow-up of the patient. Doesn’t sound so bad in light of the alarmist sound-bite at the end about patient protections.

Now if the study involved a drug that was not already widely accepted then that is a different story. For example- Polyheme was a blood substitute that was universally compatible and didn’t need refrigeration. This stuff looked like liquid gold. The company went through all the necessary regulatory hoops and hurdles to get study approved with a waiver of consent. They randomized hypotensive trauma patients to saline vs. polyheme and whoops- they had more MIs and higher mortality in the polyheme group. (I should know, I researched the heck out of this but lost a good chunk of change when their stock tanked.)

My point is that when you are comparing two already accepted treatments for a situation in the emergency room- should consent be necessary? Would any consent obtained peri-intubation be valid? Just something to think about.

Also, the B.C. emergency department closing was quite intriguing. As an ER doc with many disgruntled partners, I can see how this would be possible.