56 N urses assume a myriad of research roles in stud- ies involving cardiovascular patient populations. These “cardiovascular research nurses” may serve independently as principal investigators on research protocols or serve supportive roles as study coordina- tors, research assistants, data collectors, and/or clini- cians implementing research protocols. Although car- diovascular research nurses encounter ethical issues in the day-to-day conduct of their research, little sys- tematic information exists about these ethical issues and how cardiovascular nurse researchers address them. Ethical concerns associated with balancing patient advocacy, subject advocacy, and study advo- cacy have been voiced. 1,2 Additionally, the increased number and scope of related, randomized clinical Journal of Cardiovascular Nursing Vol. 20, No. 1, pp 56–61 ❘ © 2005 Lippincott Williams & Wilkins, Inc. Ethical Considerations in the Recruitment of Research Subjects From Hospitalized, Cardiovascular Patient Populations Nalini Jairath, PhD, RN, Connie M. Ulrich, PhD, RN Cathaleen Ley, PhD, RN Cardiovascular research nurses play important roles in ensuring that subject recruitment is conducted in an ethically defensible manner. However, these nurses encounter many ethical challenges in the course of research. Sole reliance on regulatory mechanisms such as institutional review board oversight and adherence to legal requirements does not necessarily ensure human subjects’ protection or the scientific integrity of researchers (J Law Med Ethics. 2002;30:411–419). Therefore, this article discusses 3 additional ethical considerations associated with recruiting hospitalized cardiovascular patients for research studies. These include (a) the role of the family and patient-delegated “gatekeepers,” (b) the effect of transient and subtle mental status changes upon the consent process, and (c) the effect of conflicting patient priorities. This content is illustrated using the authors’ experiences recruiting hospitalized coronary artery bypass graft surgical patients for a research study. KEY WORDS: cardiovascular nursing, cardiovascular patients, ethics, informed consent, study recruitment Nalini Jairath, PhD, RN Dean, School of Nursing, The Catholic University of America, Washington, DC. Connie M. Ulrich, PhD, RN Assistant Professor, School of Nursing, University of Pennsylvania, Philadelphia, Pa. Senior Fellow, Department of Medical Ethics, Center for Bioethics, University of Pennsylvania, Philadelphia, Pa. Senior Fellow, The Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pa. Cathaleen Ley, PhD, RN Assistant Professor, School of Nursing, Towson University, Towson, Md. The study described in this article was supported through a R15 AREA Grant NR04496 from the National Institute of Nursing Research. Corresponding author Nalini Jairath, PhD, RN, School of Nursing, Gowan Hall, The Catholic University of America, Washington, DC 20064 (e-mail: jairath@cua. edu).