Essay about Informed Consent

Katz states this about informed consent, “to suggest that informed consent with remain a fairy tale as long as the idea of joint decisionmaking, based on commitment to paint autonomy and self-determination, does not become an integral aspect of the ethos of medicine and the law of informed consent” (222).

In their article, “The Concept of Informed Consent,” Faden and Beauchamp give two varying definitions of informed consent, namely sense one and sense two. Sense one is defined as autonomous authorization, meaning that the patient or subject agrees and then gives authority to move forward with a proposal (Vaughn 191). The authors give four conditions that have to be met for informed consent to be recognized: the patient has to understand the information presented to her, there should be no manipulation or coercion, and she has to intentionally give her authorization (Vaughn 191). Faden and Beauchamp also note that the fourth condition, where the patient gives her authorization, is pivotal in this sense since it differentiates autonomous authorization

There have been questions about the morals and ethics behind prisoner research for a long time. Laws were even made to restrict and prevent research on prisoners. An example of such laws is the Nuremburg code which was made because of inhumane research being conducted in concentration camps during WWII. Prisoners are now considered a vulnerable population and research is extremely restricted because of this. Prisoners shouldn't be allowed to participate in scientific research because they can be manipulated, it can be dangerous, and they aren't educated/smart enough to comprehend the tests being conducted.

The Doctor and Patient relationship aspect of Medicine has changed drastically in the last twenty years. It has evolved from paternalism (the doctor makes the decision for the patient) to shared decision making where the patient is considered an equal partner in his/her own health related decisions. Informed consent is the cornerstone for this view. When a patient or a research subject makes an autonomous decision after understanding, the risks and benefits involved with the decision is Informed consent. Complete Informed consent covers the following components: competency, disclosure, comprehension and voluntary. Competency refers to the requirement for the individual to be of legal age and be mentally competent to understand the process.

Patient informed consent refers to the situation where the patient is fully informed on the consequences of their health care decision after which the patient gives the decision. For there to be informed consent, there are five elements that must be discussed. The first is the nature of the patient's decision then the applicable alternatives to the proposed intervention. Third are the risks, benefits and uncertainties associated with each of the alternatives. Fourth is the assessment of the patient's understanding and last is the acceptance of the intervention or an alternative by the patient. Before the patient's consent is considered to be valid, the patient's competency to make the decision must be addressed. The criteria for evaluating the patient's competency is clearly stated in section 3 of the 2005 Mental Capacity Act which states that provided the person is able to understand, retain and use information provided and to communicate their decision in any way such as talking or sign language, they are competent to make a decision. If a patient is treated against their refusal to consent, it amounts to the tort of battery or can also be considered the crime of assault. In addition to this, laws that touch on human rights reinforce the importance of the protection of the physical integrity of the individual in terms of their right to respect of their private life. Therefore, refusal of medical treatment is a human right.

Every patient has a right to decide on their own course of treatment and freely consent to that treatment. In order to make an educated decision they must be provided with the proper information to make an informed choice (Opinion 8.08 - Informed Consent, 2006). It is the physician’s legal and ethical obligation to provide this information when making their recommendation on treatment. The choices given must be in accordance with good medical practice (Opinion 8.08 - Informed Consent, 2006). The informed consent is the legal policy, either written or verbal, that gives full disclosure of all the information including potential risks that is applicable to the patient’s condition and treatment being offered (Kazmier, 2008).

INFORMED CONSENT : Valid consent is impossible. To date, foetal tissue transplants have been handled as any other organ transplants under the UAGA, thus requiring consent of next of kin. The mother cannot give morally legitimate consent, since she initiated the termination of the pregnancy. Elimination of consent, however, would further turn the unborn child into an object; it would be inconsistent with the fact that, biologically, the developing foetus does not interpret the woman’s tissue. The UAGA and the NIH Panel both fail to discern the conflict between normal organ transplants and the function of foetal tissue. In the instance of foetal tissue, the mother is presumed to be the one who gives consent to the use of the tissue for the transplant (or for some other kind of experimentation). Granting to the normal understanding of proxy consent, her role assumes that she is working in the best interest of the unborn child. However, she is also the one who has initiated the final termination of pregnancy. Just quoting the part of the act dealing with informed consent stated in the NewZealand legislation

Explain how and why the concept of informed consent is critical to issues of euthanasia (active and passive) as well as physician-assisted suicide. Informed consent is a process for getting permission before conducting a healthcare intervention on a person, autonomy at its best. In physician assisted suicide we have the informed consent of the patient requesting the help to die. In this instance the patient is the direct cause or their own death, they just require the physician to help them get the medicine needed to end their life, they decide where and when to do it, and they are competent when making this decision. This is important when it comes to the law and the physician possibly being sued. In active euthanasia the physician gives

Informed consent stands for self-determination and respect for autonomy. Autonomy is the most influential ethical principle and the main focal point in health care. It is a major concept in relation to informed consent and its simplest form can be seen as the patient’s right to determine what will or will not be done to his or her body. Expanding societal values and evolving patient centred healthcare system influences nursing practice greatly. In Canada, physicians are legally responsible for obtaining informed consent but nurses are also involved in every aspect of the informed consent process. For e.g. Nurses can perform this role when they notice that patients

When a patient needs to have a medical procedure performed, they must first consent to the procedure. Before accepting or rejecting the treatment, the practitioner is required to give the patient information pertaining to the risks and benefits of the procedure, as well as available alternatives. Additionally, the patient must be mentally competent enough to make an informed decision, and not be manipulated or coerced into a decision.

GCP requires that Investigators receive adequate training on performing the study, including obtaining Informed Consent, and that patients receive adequate information about the study, what is expected, and the risks of participating. A complete description of what is required is also available online at the OHRP website.251 These sections and activities are expanded in special circumstances, such as emergency procedures, and studies with children, captive (e.g. prisoner) populations, mentally incompetent individuals, etc.

Informed consent is supposed to show that the patient has been informed of the possible risks or consequences, typically for treatment they are agreeing to receive from a doctor. A person might be faced with giving informed consent in research settings, specialized treatments, and/or routine appointments with any health care provider. In the medical field physicians must obtain informed consent from every patient/patient representative in order to treat the patient without leaving themselves open to a lawsuit for negligence.

Informed consent is an integral part of the medical process, but what is it? How can the principles of Informed Consent conflict with each other or with patient care? It is important to examine Informed Consent very carefully and explore how the principles of Beneficence and Patient Autonomy work with each other for the best interests of the patients, even if the patient is refusing some treatment that is important in the standard of care. However, it may be possible that Informed consent and these elements work against one another, and conflict with the best interests of the patient.

Modern law reflects this idea: “certain forms of research with prisoners are permissible but often require review and approval from several agencies.” (oprs.usc). After decades of developing these laws, one would think that the laws reflect a careful, ethical way of testing on prisoners. In other words, prisoners should be better protected than the average person in medical testing, but that does not mean medical experimentation should be abolished for prisoners. Again, modern law carries this sentiment because “detention centers generally reserve the right to disallow a research activity from going forward at their facility.” (oprs.usc). Beyond a legal standpoint, there is also an argument to be made about the freedom and rights of prisoners. Should a prisoner not be allowed to participate in experiments (of course if complete consent is given). Prisoner experimentation, while it should be under harsher and more stringent regulations, should not be disallowed completely, for both the freedom and right of the prisoner and for large medical

“Respect for human beings involves giving due scope to peoples capacity to make their own decisions. In the research context, this normally requires that participation be the result of a choice made by the participants” (NHMR, 2007, p.3).  Freegard 2012 (p.60), states that “respecting the rights of others,” includes a responsibility for Health professionals “to let others know about their rights” and that this forms the basis of an informed consent.