WHAT IS CONSENT?
As written in Miller-Keane Encyclopedia
and Dictionary of Medicine, consent is a voluntary agreement with an action proposed
by another. If a person is giving consent, he must be sufficient in their
mental capacity. A person who is a baby, which is mentally incompetent, or is
under influence of drugs, is not in mentally stable for giving consent.
WHAT IS AN INFORMED
An informed consent is consent of a
client where the principles of autonomy and privacy are followed. This has
become the requirement in decision making for health care and research Centre.
are 7 criteria in defining an informed consent:
to understand and to decide.
of material information.
of a plan.
of terms (3) and (4).
in favor of a plan.
of the plan.
A person who gives an informed consent must
meet all of these criteria but if the person rejects the plan, that person must
have an informed refusal.
Informed consent is defined by
permission given by patient to doctor or other medical team regarding any
procedure regardless involving surgical or non-surgical. Patient will be explained
the purpose, indication, contraindication, side effect and benefit regarding
the procedure. Informed consent will be obtaining once patient is understood
and a two-way communication (questioning and answering) was achieved.
Informed consent is a medico legal subject
which if it is not performed correctly, it may affect the patient’s
understanding and health. Some patient may sign the consent blindly without
aware of the consequences, as all procedure have its benefit and risk.
Misunderstanding may sometimes happen among the informer and receiver when language
barrier is one of the issue. Misinterpretation of language among them might
lead to different outcome. Patients also have their rights to accepts, refuse
and argue about the decision that has been made by them, but it is also the
informer’s responsibility to explained about the details.
ETHICAL PRINCIPLES FOR
CONDUCTING RESEARCH WITH HUMAN PARTICIPANTS.
Medical research involving human beings
have created a lot of potential pitfalls that led to tragedies in the last
In 1963 in Brooklyn; Jewish Chronic
Diseases Hospital, a cancer cells were injected into debilitated elderly
patients just to see if they would immunologically reject the cells and in
1972, Willow Brook State Hospital in New York; a retarded child was deliberately
infected with viral hepatitis to study its natural history. So, it is clear
that various cultures such as Persia, Ancient and Greece have attempted to
regulate medicine and protect patient rights. Due to all of these cases, they
were trying to avoid mistakes made in the past and to provide guidance for the
These are the resulted in a series of International
Declarations and Conventions which underpin all research involving human
Code (1947) set out ten key points for responsible research with
human participants, including the need to obtain informed consent,
the importance of proper planning and conduct, and the
need for beneficence towards participants.
Council of Europe (CoE) was created in 1949 and established the European
Convention on Human Rights in 1953, which is now also embedded in
Member States’ legislation.
of Helsinki (1964) developed these ethical principles further by
looking at issues such as informed consent in more detail.
further Convention which specifically addresses human rights and
biomedicine was produced in 1997 in the light of new advances in research.
According to The US Belmont Report, they
have the most concise summary of rights and obligations in terms of research
and, as such, provide the foundation for research ethics guidance in several
places around the globe. The Belmont Report includes three ‘basic ethical principles’ for judging the ethical treatment of
for persons: The personal
dignity and autonomy of individuals must be recognized and there must be
special protections for persons with ‘diminished autonomy’ (e.g. children
Beneficence: Researchers have an obligation to
protect persons from harm by maximizing the anticipated
benefits and minimizing the risk of harm
Justice: The benefits and burdens of
research must be distributed fairly.
The Belmont Report also includes that to
ensure informed consent to be
ethically valid; it must include components such as:
informed consent must be clear.
participant understood about the explanations and they were given chance to
question any doubt.
participant joint the research voluntarily without any outside event.
is fully competent to involve in the research.
must authorize their participation in the research study