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A review of the following aspects of Indian Health Service (IHS) activities has been conducted: medical research involving American Indian subjects; research on the control of trachoma; and permanent sterilization of Indians at IHS facilities and contract facilities. Fifty-six proposals for research projects were reviewed, and, of the 36 projects which entailed a service or treatment to Indians, none appeared to expose participants to serious risks, and the patient consent forms reviewed at selected projects did not indicate any significant inadequacies. However, IHS procedures for approving and monitoring research projects need to be strengthened. It was concluded that the drugs used by the IHS to treat trachoma did not subject the Indian children to any unnecessary risk. A review of sterilization procedures in the Aberdeen, Albuquerque, Oklahoma City, and Phoenix areas showed that these areas were generally not in compliance with IHS regulations. Although there were consent forms in the medical files, most of these forms did not comply with IHS requirements. HEW should expedite its efforts to have a standard consent form which provides for full disclosure of the information required by the regulations and provide training to their physicians and administrators so that they fully understand the requirements concerning sterilization of persons under 21 and persons who are mentally incompetent and concerning obtaining informed consent in accordance with HEW sterilization regulations.

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