Term Paper on "Informed Consent in Medical Practice"

Term Paper 5 pages (1692 words) Sources: 5

[EXCERPT] . . . .

Biomedical Ethics

Patients and their families are prime partners in their medical care. Whenever you visit a health care facility, you usually receive suggestions about the required intervention. Most people follow these suggestions, but they are not required to do so. If you are an adult and have the capacity to make choices, you are the only person who can choose whether to get intervention and which therapy to get. The process of informed consent ensures that this is realized. All medical procedures require the approval of the patient before the medical care plan is carried out. This study explores the concept of informed consent, its ethical implications for treatment, and application in the research field.

Legal aspect of informed consent

States have developed laws of informed consent to regulate certain kinds of interaction between patients and health providers. These laws list the kinds of information entitled to patients, to make an advised decision regarding medical care, treatment, and assessments. They are applicable to physicians and nurses. They vary depending on the jurisdiction and are often established and implemented depending on the prevailing circumstances. For instance, various states determine certain details be made public regarding breast cancer interventions or for medical studies. The difference is clear as other states call only for "reasonable" information, but others require "complete and full disclosure" (Leino-Kilpi, 2010). For successful practice of informed consent, the details that are given must be recognized. The individual shares this liability, since the doctor will not know what the patient has not understood, unless the patient asks questions. The victim deserves the opportunity to consider the details and ask questions.

For kids or those who are incapable to decide for themselves, the lawful guardian or parent is fully accountable for making the decision, obtaining the information, and approving to the consent form. Nevertheless, that does not mean that the kid or an individual who is not regarded psychologically qualified is always ignored in the procedure. Some features need the approval of kids before entering a research study, regardless of whether the parents have decided on the kid's part. Assent implies that though the parent approves the forms by signing them, the kid should also give an OK before initiating the medical procedure or treatment (Chin & Lee, 2008). From the same perspective, people who cannot handle their everyday matters due to psychological problems or impaired thinking may be able to comprehend the medical scenario and create their desires in public. Information must be supplied to them in a mode that is easy to comprehend, and request what they would desire to do.

On occasion, that a participant becomes incapable to understand information and make his/her desires known, another individual could be requested to partake in the informed consent procedure. The individual can be chosen several ways. One way to select the person is to set up a durable power of attorney for medical care (also known as the power of attorney in healthcare). Given that you cannot speak for yourself, the individual you chose becomes lawfully responsible for making health care choices on your behalf. This individual is sometimes known as your agent, surrogate, or proxy. Some states have limited the ability of proxies to voice certain demands. Another option relates to court-appointed proxies or surrogates. The judge selects this person to create health care choices for you. In case an individual is incapable of making choices for themselves, someone else like the doctor, family member, facility, or a friend may ask/petition the judge to designate a representative. The procedure varies from country to country (Portenoy & Bruera, 2013).

Informed Consent in Medical Treatment

The discussion of informed consent has been created mainly through the 'languages' of law and ethical viewpoint. The lawful doctrine of informed consent in medical treatment has progressed mostly through the medium of case law. In particular, legal courts have resolved patients' claims that doctors did not obtain proper permission for the activities they performed. Because of the adversarial and the retrospective nature of the legal framework, the idea of informed consent in medical treatment has embraced a defensive angle. This works out, for example, through increased attention to disclosure of threats. While the risk-management factors of informed consent cannot be ignored, it has had essential and positive practical and ethical repercussions for the medical practice (Kluge, 2010).

In contrast to the courts' focus on retrospectively evaluating a doctor's actions, moral viewpoint has focused on guaranteeing the individual's right to create autonomous decisions. Bioethicists see informed consent as the practical embodiment of respect for persons and individual autonomy. Autonomy includes thoughts of self-governance, privacy, and liberty rights. This moral structure keeps the individual's right and ability to create options that are reliable with his or her principles. As a result, choices become the main basis for informed consent. From an ethical viewpoint, the doctor's disclosure responsibility is a requirement for the practice of individual autonomy unlike the central focus of informed consent (Kluge, 2010).

An alternative perception necessitates that a lawfully legitimate consent be obtained before a medical procedure is carried out, thereby finding informed consent in the world of social guidelines and institutional settings. This definition deals with the institutional guidelines of consents and does not necessarily emphasize on consent as an independent act. Rather, informed consent is determined as the individual's institutionally or lawfully effective permission. The approval is legitimate if it occurs within the laws that regulate specific institutional practices (Chin & Lee, 2008).

Informed Consent in Research

Official requirements and obligations for informed consent evolved from the standards regulating both human research and clinical medicine. Informed consent in the perspective of research has progressed in parallel with but mostly separate from informed consent in medical treatment. In America, the practice of informed consent in research and the procedures followed when obtaining the consent is challenging. It is always controlled by government rules.

Introduction of the Common Rule stipulates rules for human samples in research that apply to almost all government divisions financing research. The document needs that eight components of information about the research are provided to the individual or his/her lawfully approved representative. These components include

A declaration that the research is investigative along with a definition of research and its goals, details of expected risks,

A definition of expected benefits to sample members and others,

Information regarding reasonable alternatives,

A declaration clarifying the effects of research contribution for the privacy of the subjects,

A declaration about the settlement if injury occurs,

Details about how the subject can obtain answers to relevant research questions, and a declaration about the voluntary nature of research contribution and the subject's right to pull out (Kluge, 2010).

Informed Consent in Vulnerable Populations

The concepts of disclosure, capacity voluntarism, and understanding structure informed consent in research and medical treatment. Concerns about these concepts -- especially capacity and voluntarism, underlie the additional regulating rights for "special populations." Samples may be considered vulnerable from physical conditions or cognitive impairment. The groups may overlap, but prisoners are regarded most vulnerable because of circumstances. On the other hand, children and mentally impaired persons are regarded vulnerable due to cognitive impairment (Kluge, 2010).

Prisoners

Research including prisoners presents challenges to the requirement of voluntarism. Many have suggested that inmates, by virtue of circumstances, might feel forced to accept to do things that non-prisoners might not. The issue is that imprisoned individuals may have an affected capability to make choices that are free of coercion. The review boards are required to make sure that research contribution is not necessarily motivated by inducements such as enhancement in general living conditions, quality of health care, food, opportunities, or amenities. The review boards must also make sure that non-prisoner volunteers would consider the threats engaged to be acceptable. It includes ensuring selection of subjects… READ MORE

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