Ethical considerations for critical care research

Ethical lapses are almost never a case of bad people, doing bad things, for no good reason. More often they are good people, doing bad things, for good reasons. (Marcia Angell, previous Editor-in-Chief (1988 - 2000), New England Journal of Medicine.) Critical illness carries high morbidity and mortality worldwide, with a disproportionate burden of critical illness in low- and middle-income countries, where access to intensive care is particularly limited. Without research in the intensive care unit (ICU) population, we are unlikely to improve our understanding of how to safely and effectively manage a wide range of diseases and injuries, minimise discomfort, reduce organ dysfunction, improve survival, improve quality of life in survivors of critical illness, and ensure rational and equitable use of scarce resources. Clinical research in the critical care environment is therefore essential to inform best practice ('evidence-based care').