Vulnerable Populations Checklists- Women, Fetuses, Neonates



|IRB-HSR# or UVA Study Tracking       PI:       |

|Reviewer:       Meeting Date:       |

| Pregnant Women, Human Fetuses |

| |CONDITION MET? |REVIEWER COMMENTS |

|45 CFR 46.204 Research involving pregnant women or fetuses | | |

|Pregnant women or fetuses may be involved in research only if ALL the | | |

|following conditions are met: | | |

|Where scientifically appropriate, preclinical studies, including | YES NO NA | |

|studies on pregnant animals, and clinical studies, including studies on | | |

|non-pregnant women, have been conducted and provide data for assessing | | |

|potential risks to pregnant women and fetuses; | | |

|The risk to the fetus is caused solely by interventions or | YES NO |Which criteria applies? |

|procedures that hold out the prospect of direct benefit for the woman or the | |The risk to the fetus is caused solely by interventions |

|fetus; or, if there is no such prospect of benefit, the risk to the fetus is | |The procedures hold out the prospect of direct benefit for |

|not greater than minimal and the purpose of the research is the development | |the woman or the fetus |

|of important biomedical knowledge which cannot be obtained by any other | |There is no prospect of benefit, the risk to the fetus is not|

|means; | |greater than minimal and the purpose of the research is the |

| | |development of important biomedical knowledge which cannot be|

| | |obtained by any other means; |

|Any risk is the least possible for achieving the objectives of | | |

|the research; |YES NO | |

|If the research holds out the prospect of direct benefit to the | YES NO |Which criteria applies? |

|pregnant woman, the prospect of a direct benefit both to the pregnant woman |NA |The research holds out the prospect of direct benefit to the |

|and the fetus, or no prospect of benefit for the woman nor the fetus when | |pregnant woman. |

|risk to the fetus is not greater than minimal and the purpose of the research| |There is a prospect of a direct benefit both to the pregnant |

|is the development of important biomedical knowledge that cannot be obtained | |woman and the fetus. |

|by any other means, her consent is obtained in accord with the informed | |There is no prospect of benefit for the woman nor the fetus, |

|consent provisions of the Federal Regulations (45CFR46 subpart A); | |the risk to the fetus is not greater than minimal, the |

| | |purpose of the research is the development of important |

| | |biomedical knowledge that cannot be obtained by any other |

| | |means, and the mothers consent will be obtained in accord |

| | |with the informed consent provisions of the Federal |

| | |Regulations (45CFR46 subpart A); |

|If the research holds out the prospect of direct benefit solely to the fetus | YES NO | |

|then the consent of the pregnant woman and the father is obtained in accord |NA | |

|with the informed consent provisions of the Federal Regulations (45CFR46 | | |

|Subpart A) , except that the father's consent need not be obtained if he is | | |

|unable to consent because of unavailability, incompetence, or temporary | | |

|incapacity or the pregnancy resulted from rape or incest. | | |

|Each individual providing consent is fully informed regarding the reasonably | YES NO | |

|foreseeable impact of the research on the fetus or neonate | | |

|For children (per state law person ................
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