BACKGROUND Prehospital ambulance based research has unique ethical considerations due to urgency, time limitations and the locations involved. We sought to explore these issues through interviews with experts in this research field. METHODS We undertook semi-structured interviews with expert informants, primarily based in the UK, seeking their views and experiences of ethics in ambulance based clinical research. Participants were questioned regarding their experiences of ambulance based research, their opinions on current regulations and guidelines, and views about their general ethical considerations. Participants were chosen because they were actively involved in, or in their expert capacity (e.g. law) expressed an interest in, ambulance based research. RESULTS Fourteen participants were interviewed including principal investigators, researchers, ethicists and medical lawyers. Five major themes were identified: Capacity, Consent, Clinical Considerations, Consultation and Regulation. Questions regarding consent and capacity were foremost in the discussions as all participants highlighted these as areas for concern. The challenges and use of multiple consent models reflected the complexity of research in this environment. The clinical theme referred to the role of paramedics in research and how research involving ambulance services is increasingly informing improvements to patient care and outcomes and reducing the burden on hospital services. Most felt that, although current regulations were fit for purpose, more specific guidance on implementing these in the ambulance setting would be beneficial. This related closely to the theme of consultation, which examined the key role of ethics committees and other regulatory bodies, as well as public engagement. CONCLUSIONS By interviewing experts in research or ethics in this setting we were able to identify key concerns and highlight areas for future development such as improved guidance.

中文翻译：

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基于院前救护车的研究中的道德考量：专家线人的定性访谈研究。

背景技术由于紧急情况，时间限制和所涉及的位置，基于院前救护车的研究具有独特的伦理考虑。我们试图通过与该研究领域的专家进行访谈来探讨这些问题。方法我们对主要来自英国的专家线人进行了半结构化访谈，以征询他们在基于救护车的临床研究中的道德观念和经验。询问参与者有关他们基于救护车的研究的经验，对现行法规和准则的看法以及对他们的一般道德考虑的看法。之所以选择参与者，是因为他们积极参与或以专家身份（例如法律）对基于救护车的研究表示了兴趣。结果接受了包括主要研究人员在内的14位参与者的访谈，研究人员，伦理学家和医学律师。确定了五个主要主题：能力，同意，临床考虑，咨询和法规。在讨论中，与同意和能力有关的问题最为重要，因为所有与会者都强调了这些是值得关注的领域。多重同意模型的挑战和使用反映了这种环境下研究的复杂性。临床主题指的是护理人员在研究中的作用，以及涉及救护车服务的研究如何越来越多地为改善患者护理和治疗效果以及减轻医院服务负担提供信息。大多数人认为，尽管当前的法规符合目的，但在救护车环境中实施这些法规的更具体的指导将是有益的。这与协商的主题密切相关，审查了道德委员会和其他监管机构的关键作用，以及公众参与。结论在这种情况下，通过采访研究或伦理学专家，我们能够确定关键问题并突出未来发展的领域，例如改进的指导。