Ethical Justification for Deferral of Consent in the AcT Trial for Acute Ischemic Stroke

Ethical Justification for Deferral of Consent in the AcT Trial for Acute Ischemic Stroke
Research Article
Hannah Faris, Brian Dewar, Dar Dowlatshahi, Alnar Ramji, Carol Kenney, Stacey Page, Brian Buck, Michael D. Hill, Shelagh B. Coutts, Mohammed Almekhlafi, Tolulope Sajobi, Nishita Singh, Arshia Sehgal, Richard H. Swartz, Bijoy K. Menon, Michel Shamy
Stroke, 23 May 2022
Abstract
The AcT trial (Alteplase Compared to Tenecteplase) compares alteplase or tenecteplase for patients with acute ischemic stroke. All eligible patients are enrolled by deferral of consent. Although the use of deferral of consent in the AcT trial meets the requirements of Canadian policy, we sought to provide a more explicit and rigorous approach to the justification of deferral of consent organized around 3 questions. Ultimately, the approach we outline here could become the foundation for a general justification for deferral of consent.