Comparative conclusions: towards a global vision of informed consent?

Vansweevelt, Thierry; Glover‐Thomas, Nicola

doi:10.4337/9781788973427.00020

Cited by 3 publications

(8 citation statements)

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“…Globally, consent laws and practices differ, shaped by differing legal standards, decision-making norms and bioethical perspectives 4. Though the authors do not claim to know consent practice in every country and culture, many jurisdictions expect physicians to disclose information that a ‘reasonable doctor’ would provide, judging adequacy by professional custom 5. However, in a number of jurisdictions, for instance, the UK and many states within the USA, a more patient-driven standard is applied, requiring doctors to disclose risks a reasonable patient would want to know 1 2.…”

Section: The Global Landscape Of Consentmentioning

confidence: 99%

“…However, standards may differ depending on the urgency of the surgery, with time for consideration expected for elective procedures but not necessarily required for more urgent procedures; for example, an emergency caesarean section, where oral consent may be acceptable. Cosmetic surgery is an example of a non-urgent, non-essential procedure, where many countries mandate stricter disclosure of risks personalised to the individual patient 5…”

Section: The Global Landscape Of Consentmentioning

confidence: 99%

“…In the USA and UK, patients typically bear the burden of demonstrating they suffered an injury due to inadequate risk disclosure. However, in Germany and France, the burden of proof falls on physicians to show they provided sufficient information 5. Sweden, Finland and New Zealand are examples of countries who take a ‘No-fault’ approach to compensating for injury received while undergoing treatment.…”

Section: The Global Landscape Of Consentmentioning

confidence: 99%

“…In the paternalistic model,9 healthcare professionals can obtain patients’ signatures authorising consent to a procedure without substantive information exchange or counselling. Another divergence is the level of family involvement; for example, countries such as India and China,5 where cultural norms often lead to treatment decisions being made collectively with relatives, rather than relying on individual autonomy.…”

Section: The Global Landscape Of Consentmentioning

confidence: 99%

See 3 more Smart Citations

Global considerations for informed consent with shared decision-making in the digital age

St John,

Moore,

Pillarisetti

et al. 2024

BMJ EBM

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Section: The Global Landscape Of Consentmentioning

confidence: 99%

Section: The Global Landscape Of Consentmentioning

confidence: 99%

Section: The Global Landscape Of Consentmentioning

confidence: 99%

Section: The Global Landscape Of Consentmentioning

confidence: 99%

See 2 more Smart Citations

Global considerations for informed consent with shared decision-making in the digital age

St John,

Moore,

Pillarisetti

et al. 2024

BMJ EBM

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“…This principle prescribes acknowledging people's autonomy while at the same time protecting those persons whose autonomy is diminished ( 23 ). The principle of informed consent has globally been embraced as a core principle within bioethics and is enshrined in various supranational legal instruments ( 24 ) 8 .…”

Section: Competence and Informed Consentmentioning

confidence: 99%

Empowering the voiceless. Disorders of consciousness, neuroimaging and supported decision-making

Istace

2022

Front. Psychiatry

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Patients suffering from (Prolonged) Disorder of Consciousness are deemed incompetent to give valid informed consent due to the presumed impairment of their cognitive functions and the impossibility to communicate with them. Neuroscientists have, however, discovered ways in which communication with some of these patients might be possible by using neuroimaging. This would for the first time make it possible to include them in the decision-making on their own medical treatment. In this article, I elaborate on the prospect of communicating with patients with impaired consciousness in order to obtain their informed consent. I first map the current state-of-the-art in neuroimaging research that exhibits the possibility of communicating with some of these patients. Secondly, I examine how obtaining informed consent from these patients might be possible, given that the specificities and limitations of communication via neuroimaging render the task of assessing their competence rather difficult. Thirdly, I identify some of the important ethical and legal considerations that have to be taken into account before introducing neuroimaging in clinical practice as a means to obtain informed consent. Lastly, I look into the concept of supported decision-making and how this concept relates to the use of neurotechnology to support minimally conscious patients in their abilities to decide over their own medical treatment.

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Factors associated with the delay in informed consent procedures of patients with ST-segment elevation myocardial infarction and its influence on door-to-balloon time: a nationwide retrospective cohort study

Maimaitiming,

Ma,

Dong

et al. 2024

Journal of Translational Internal Medicine

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Background and Objectives ST-segment elevation myocardial infarction (STEMI) is the deadliest and most time-sensitive acute cardiac event. However, failure to achieve timely informed consent is an important contributor to in-hospital delay in STEMI care in China. We investigated the factors associated with informed consent delay in patients with STEMI undergoing percutaneous coronary intervention (PCI) and the association between the delay and door-to-balloon time. Methods We conducted a nationally representative retrospective cohort study using patient data reported by hospital-based chest pain centers from 1 January 2016 to 31 December 2020. We applied generalized linear mixed models and negative binomial regression to estimate factors independently predicting informed consent delay time. Logistic regressions were fitted to investigate the association of the informed consent delay time and door-to-balloon time, adjusting for patient characteristics. Results In total, 257, 510 patients were enrolled in the analysis. Mean informed consent delay time was 22.4 min (SD = 24.0), accounting for 39.3% in door-to-balloon time. Older age (≥65 years) was significantly correlated with informed consent delay time (RR: 1.034, P = 0.001). Compared with ethnic Han patients, the minority (RR: 1.146, P < 0.001) had more likelihood to extend consent giving; compared with patients who were single, longer informed consent time was found in married patients (RR: 1.054, P = 0.006). Patients with intermittent chest pain (RR: 1.034, P = 0.011), and chest pain relief (RR: 1.085, P = 0.005) were more likely to delay informed consent. As for transfer modes, EMS (RR: 1.063, P < 0.001), transfer-in (RR: 1.820, P < 0.001), and in-hospital onset (RR: 1.099, P = 0.002) all had positive correlations with informed consent delay time compared to walk-in. Informed consent delay was significantly associated with prolonged door-to-balloon time (OR: 1.002, P < 0.001). Conclusion Informed consent delay is significantly associated with the door-to-balloon time which plays a crucial role in achieving better outcomes for patients with STEMI. It is essential to shorten the delay time by identifying and intervening modifiable factors that are associated with shortening the informed consent procedure in China and other countries.

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Comparative conclusions: towards a global vision of informed consent?

Cited by 3 publications

References 0 publications

Global considerations for informed consent with shared decision-making in the digital age

Global considerations for informed consent with shared decision-making in the digital age

Empowering the voiceless. Disorders of consciousness, neuroimaging and supported decision-making

Factors associated with the delay in informed consent procedures of patients with ST-segment elevation myocardial infarction and its influence on door-to-balloon time: a nationwide retrospective cohort study

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