The Concept of Voluntary Consent

Abstract

Our primary focus is on analysis of the concept of voluntariness, with a secondary focus on the implications of our analysis for the concept and the requirements of voluntary informed consent. We propose that two necessary and jointly sufficient conditions must be satisfied for an action to be voluntary: intentionality, and substantial freedom from controlling influences. We reject authenticity as a necessary condition of voluntary action, and we note that constraining situations may or may not undermine voluntariness, depending on the circumstances and the psychological capacities of agents. We compare and evaluate several accounts of voluntariness and argue that our view, unlike other treatments in bioethics, is not a value-laden theory. We also discuss the empirical assessment of individuals' perceptions of the degrees of noncontrol and self-control. We propose use of a particular Decision Making Control Instrument. Empirical research using this instrument can provide data that will help establish appropriate policies and procedures for obtaining voluntary consent to research.

Capable of More: Some Underemphasized Aspects of Capacity Assessment

“…It strings our choices together in a way that keeps them from being arbitrary or cross sectional; it gives life coherence. 61,62 Because self and circumstances vary across time, Nelson et al find authenticity unnecessary to the concept of informed consent. 62 Still, many see authenticity as integral to capacity concerns and even as the object of the respect that autonomy warrants.…”

“…61,62 Because self and circumstances vary across time, Nelson et al find authenticity unnecessary to the concept of informed consent. 62 Still, many see authenticity as integral to capacity concerns and even as the object of the respect that autonomy warrants. 63,60, 61 Fistein pointed out the face validity of "long-standing values … [as] morally significant," going so far as to imagine "an argument that the capacity for autonomous action is retained as long as … [these values] persist."…”

Are Pediatricians Complicit in Vitamin K Deficiency Bleeding?

“…18 Persuasion includes removal of biases, 19 a requisite step in negotiating recommended care. For example, if parents believe that an oral preparation is more natural and therefore more effective, the clinician appropriately gives best available information about efficacy.…”

Factors Related to Voluntary Parental Decision-Making in Pediatric Oncology

“…Previous studies have lacked a careful definition of the concept of voluntariness, and none have used a quantitative assessment tool. The use of such a measure, based on a clear and conceptually justified definition, [20][21][22] can shed light on the various factors that may constrain voluntariness in parents making medical decisions for their children. Such information is important, especially because parents' experiences of informed permission may provide the foundation for the parentphysician relationship, 9 particularly in the context of life-threatening or chronic illness.…”

“…[20][21][22] Previous reports based on this study include a description of the psychometrics and validity of the new measure of voluntariness. 21,22 Validity was tested by examining associations with trust, self-efficacy, and distress.…”