Pregnancy in women with a history of breast cancer.

This has resulted in the formation of organisations such as the UK Clinical Research Collaboration (www. ukcrc.org). However, in the two years since implementation of the regulations, recruitment into clinical trials in unconscious patients in emergency situations has been slow in the UK. The evidence base for trauma care was already seriously lacking, and the regulations did not help. Unconscious patients in emergency situations should have the right to benefit from medical research, but the 2004 regulations put this right in jeopardy. The amendment to the clinical trials regulations will be welcomed by emergency doctors. NHS research and development departments urgently need to develop guidance on how to implement this amendment. In the meantime, emergency doctors can be reassured that the new guidance allows patients to be enrolled without prior written consent if approved by the ethics committee, and that clinical trials once again have the potential to provide the evidence needed to improve emergency care.