Majority of Japanese Adults Support Emergency Clinical Research Without Prior Consent, New National Survey Shows

A nationwide survey of 1,000 adults in Japan found that 60.5% would accept enrollment in at least one emergency clinical trial scenario without prior informed consent, according to the REFINED‑IC Study Group led by Professor Masaru Suzuki (International University of Health and Welfare) and Dr. Mayumi Fukuda (National Cerebral and Cardiovascular Center).

The findings were published in JAMA Network Open*, an international journal of the American Medical Association.

*: Suzuki M, Fukuda M, et al. Public Acceptance of Emergency Research Without Prior Consent in Stroke. JAMA Network Open. 2026;9(6):e2617347.doi:10.1001/jamanetworkopen.2026.17347

Key Findings

• 60.5% accepted participation in at least one emergency scenario without prior consent
• Only 33.4% were willing to join a standard clinical trial requiring full prior consent
• Even among those unwilling to join standard trials, 44.3% accepted emergency scenarios
• Acceptance increased when treatment benefit was high and risks were low
• Public judgments reflected benefit–risk tradeoffs, urgency, and consent feasibility—not blanket rejection

Why It Matters

Stroke treatment is highly time‑sensitive, and standard consent procedures often delay care. Japan currently allows research without prior consent only in life‑threatening situations, leaving a regulatory gap for urgent but non‑fatal conditions such as stroke.

This study provides rare empirical evidence on public attitudes toward emergency research—data that have been largely absent in Japan and limited globally.

Implications

The results support ongoing discussions on:

• Ethical and legal frameworks for emergency research
• Public communication on clinical trials
• Application to other time‑critical conditions (cardiac arrest, trauma)
• Conditions under which society accepts research without prior consent
• Best practices for post‑event explanation and transparency

About the Study

Participants evaluated eight hypothetical emergency stroke scenarios varying in:

• Treatment effectiveness
• Risk of adverse effects
• Consent method (no prior consent, telephone proxy consent, standard written consent)

The study shows that the public makes context‑sensitive, medically informed decisions, rather than rejecting emergency research outright.

Funding

This work was supported by AMED (JP22oa0310011, JP25oa0439003).

Additional Information

• Study group activities
• Public information booklet

Contacts

Media Contacts

International University of Health and Welfare – Public Relations
e-mail: tokyo.pr"AT"ihwg.jp　tel: +81‑3‑5574‑3828

National Cerebral and Cardiovascular Center – Public Relations
e-mail: kouhou”AT”ml.ncvc.go.jp　tel: +81‑6‑6170‑1069

Japan Agency for Medical Research and Development (AMED)
e-mail: rinri-kyoso"AT"amed.go.jp

Research Contact

Masaru Suzuki, MD, PhD
Professor, International University of Health and Welfare
e-mail: suzuki-masaru-rh"AT"ihwg.jp

Regarding the Study Group

Mayumi Fukuda, PhD 
Director, Data Science Division
National Cerebral and Cardiovascular Center
e-mail: mfukuda"AT"ncvc.go.jp

Replace "AT" with "@".