Theories in health care and research: Theories of consent

Alderson, Priscilla; Goodey, Chris

doi:10.1136/bmj.317.7168.1313

Cited by 58 publications

(13 citation statements)

References 4 publications

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“…In the UK, the Department of Health (DoH) has published national guidelines for obtaining valid consent to treatment, 1 to ensure that specific information about procedures, their benefits and complications as well as alternative treatment is imparted to the patient 2 . Whether these processes truly address patients' needs is unknown, partly because the research field is dominated by measurements of information and recall, rather than addressing issues of patient‐defined priorities and values 3,4 . There is little published evidence about patients' experience of the consent process, and in particular, there is little evidence that distinguishes between the experiences of patients who have undergone elective compared with emergency surgery.…”

Section: Introductionmentioning

confidence: 99%

Informed consent for elective and emergency surgery: questionnaire study

Akkad

Jackson

Kenyon

et al. 2004

BJOG

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Objectives To evaluate women's experience of giving consent to obstetric and gynaecological surgery and to examine differences between those undergoing elective and emergency procedures. Design A prospective questionnaire study. Setting A large teaching hospital. Population 1006 consecutive patients undergoing elective or emergency surgery in obstetrics and gynaecology. Methods Questionnaires were administered to women who had given consent to surgery following the introduction of national guidelines and consent form. Differences in responses between elective and emergency patients were assessed using frequencies, single and multivariable analyses. Main outcome measures Patients' experience and recall of the consent process, their overall satisfaction and their views on what is important for adequate consent. Results There were significant differences between patients undergoing elective or emergency surgery. Patients undergoing emergency surgery were less likely to have read (OR 0.22) or understood (OR 0.40) the consent form, and were more likely to report feeling frightened by signing it (OR 2.52). They were more likely to report they felt they had no choice about signing the consent form (OR 2.11), and that they would have signed regardless of its content (OR 3.14). Overall, significantly more patients undergoing elective (80%) or emergency (63%) surgery reported satisfaction with the consent process. Patients were more likely to report satisfaction if they read (OR 1.80) and agreed with (OR 3.49) the consent form, and if someone checked that they understood (OR 3.09). Conclusion Patients' needs may not be adequately addressed by current guidelines for consent to treatment, particularly in emergency circumstances. The introduction of more complex forms and procedures appears to conflict with patients' need for personal communication and advocacy. The implications on the ethical and legal standing of consent are considerable.

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Section: Introductionmentioning

confidence: 99%

Informed consent for elective and emergency surgery: questionnaire study

Akkad

Jackson

Kenyon

et al. 2004

BJOG

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“…Difficulties range from practical implementation (for example, helping young children to understand the purpose of the research) to broad theoretical differences. For some researchers, the act of providing informed consent is nothing more than a formality, while others uphold it as an essential safeguard, with some even considering the issue of free choice as more important than the option that is chosen (Alderson & Goodey, 1998). This, along with issues of privacy, the nature of a true volunteer, child competence, free choice, and responsibility for one's actions (Faden et al, 1986), all influence the way informed consent procedures are implemented with young children.…”

Section: Dilemmas Of Informed Consent With Young Childrenmentioning

confidence: 99%

Meaningful informed consent with young children: looking forward through an interactive narrative approach

Mayne

Howitt

Rennie

2015

Early Child Development and Care

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Ideas about ethical research with young children are evolving at a rapid rate. Not only can young children participate in the informed consent process, but researchers now also recognize that the process must be meaningful for them. As part of a larger study, this article reviews children's rights and informed consent literature as the foundation for the development of a new conceptual model of meaningful early childhood informed consent. Based on this model, an 'interactive narrative' approach is presented as a means to inform 3-8 year old children about what their participation might involve, and assist them to understand and respond as research participants. For use with small groups, this narrative approach involves a storybook based on factual images related to the research project that is delivered via (re)telling. The narrative approach to informed consent is unique in its holistic design which addresses the specific needs of young children.

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“…They have suggested that informed consent should not be seen as the result of a purely rational and autonomous process of decision-making, based on a deep assessment and understanding of the information provided by health professionals, as it is also guided by feelings of trust in these professionals [22]. Interactions and relationships can enhance, as well as restrict, the autonomy to consent [27]. Consent is regarded as a perceived and experienced process constructed through interactions between individuals and their social contexts, where emotions, desires and feelings shape patients’ responses and decision-making.…”

Section: Introductionmentioning

confidence: 99%

A patient-centred approach to embryo donation for research

Samorinha

Silva

2016

Isr J Health Policy Res

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Most couples enrolled in Assisted Reproductive Technologies’ (ART) treatments need to make decisions regarding embryo disposition, as they are asked to sign a consent form about embryo donation for research. Beyond the current assessment of patients’ individual experiences and levels of satisfaction with care delivery, we argue that it is crucial to provide stakeholders in health systems with feedback on patients’ views about legal and regulatory frameworks. Such knowledge will lend credence and robustness to the consent that the couples give, and will contribute to the implementation of informed relational ethics in clinical practice and to improved patient-centredness in the field of ART.

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Theories in health care and research: Theories of consent

Cited by 58 publications

References 4 publications

Informed consent for elective and emergency surgery: questionnaire study

Informed consent for elective and emergency surgery: questionnaire study

Meaningful informed consent with young children: looking forward through an interactive narrative approach

A patient-centred approach to embryo donation for research

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