Ethical governance of the medical research: clinical investigation and informed consent under the new EU Medical Devices Regulation (2017/745)

Purpose: The paper focuses on the ethical appraisal of the clinical investigations (CIs) and the informed consent within the new European Union (EU) legislation on medical devices (MDs). The Regulation (EU) 2017/745 of the European Parliament and of the Council was adopted on 5 April 2017 and entered into force on 25 May 2017, repealing the Council Directives concerning Medical Devices 93/42/EEC and the Active Implantable Medical Devices 90/385/EEC. Background: For the past thirty years, the EU legislation on MDs has been updated by several directives: Council Directive 90/385/EEC on Active Medical Devices (1990); Council Directive 93/42/EEC on Medical Devices (1993) and Council Directive 98/79/EC on In vitro Medical Devices (1998) aiming to frame the MDs market development. Content: From the ethical perspective, the present article investigates the new rules concerning the CIs of the MDs for human use and accessories for such devices conducted in the EU by highlighting new regulatory aspects: (1) the framework of the clinical evaluation and CI; (2) the relevant definitions; (3) the ethical principles related to CIs; (4) the informed consent; (5) the role of the national ethics committees. Conclusions: Although the new guidelines enable an extension of the definition of "medical device" and the harmonization of the rules for "the placing on market and putting into service of the medical devices", it also regulates the MDs industry to ensure clinical benefits for patients and high standards of quality and safety.