ethique_consentment_aptitutde

The ethical‐legal requirements for adolescent self‐consent to research in sub‐Saharan Africa: A scoping review.

Wed, 01 Jun 2022 04:00:00 +0000

Bioethics; 06/01/2022
Support for the enrolment of adolescents in research has been constrained by uncertainties in parental involvement, and the lack of clarity in the ethical and legal frameworks. We conducted a scoping review to examine articles that explored the opinion of scholars on the question of adolescent consent and conditions for parental waivers in research in sub‐Saharan Africa (SSA). Guided by the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) tool, we searched electronic databases (PubMed, EMBASSE, EBSCOHOST) and also reviewed the references of articles identified for additional relevant literature. We included full text English articles focusing on adolescent consent and parental waivers in SSA that were published between 2004 and 2020. We excluded studies focusing on healthcare, theses, and reviews. We reviewed a total of 21 publications from South Africa (n = 12), Kenya (n = 4) and Botswana, Malawi, Nigeria, Uganda and Zimbabwe (n = 1 each). We identified four broad thematic issues: the current position regarding parental waivers and self‐consent; parental involvement in the consent process; the role of community approval or consent when adolescent self‐consent approaches were used; and complexities and ambiguities in legal requirements and ethical guidelines on adolescent consent. Our findings show inconsistencies and ambiguities in the existing legal and ethical frameworks within and across different countries, and underscore the need for consistent and clearer guidance on parental waivers and adolescent self‐consent. Harmonization of the legal and ethical frameworks taking into account varying contexts is critically important to ensure research on adolescents in SSA meets adolescents' specific unmet needs.
(AN 156900745); ISSN: 02699702
CINAHL Complete

Ethical Justification for Deferral of Consent in the AcT Trial for Acute Ischemic Stroke

Mon, 23 May 2022 00:00:00 +0000

Stroke. 2022 May 23:101161STROKEAHA122038760. doi: 10.1161/STROKEAHA.122.038760. Online ahead of print.

ABSTRACT

The AcT trial (Alteplase Compared to Tenecteplase) compares alteplase or tenecteplase for patients with acute ischemic stroke. All eligible patients are enrolled by deferral of consent. Although the use of deferral of consent in the AcT trial meets the requirements of Canadian policy, we sought to provide a more explicit and rigorous approach to the justification of deferral of consent organized around 3 questions. Ultimately, the approach we outline here could become the foundation for a general justification for deferral of consent.

PMID:35603597 | DOI:10.1161/STROKEAHA.122.038760

Professional ethics and decision making in perinatology

Sat, 21 May 2022 08:23:41 +0000

Author Names: Chervenak F.A.,McCullough L.B.

Database Source: Embase Weekly Updates

Journal Title: Seminars in Perinatology,Seminars in Perinatology

Article Title: Professional ethics and decision making in perinatology

Year: 2022

Issue: 3

Volume: 46

Abstract: Objective: We describe the essential elements of professional ethics in perinatology and explain how professional ethics in perinatology should guide decision making with pregnant patients and with parents. Finding(s): Professional ethics in perinatology draws on two ethical principles, beneficence and respect for patient autonomy, the ethical concept of the fetus as a patient, and the best interests of the child standard and the concept of parental permission. Counseling about intrapartum management should be based on the ethical concept of the fetus as a patient and on the role of the pregnant patient as the ultimate decision maker. Counseling about setting ethically justified limits on perinatal clinical management should be based on four specified concepts of futility, but not on quality-of-life futility. Counseling about innovation and research should emphasize that investigation clinical management is an experiment. Conclusion(s): Professional ethics in perinatology is an essential component of perinatal practice, innovation, and research Copyright © 2021 Elsevier Inc.

Ethics of Facial Transplantation: The Effect of Psychological Trauma Associated With Facial Disfigurement on Risk Acceptance and Decision Making

Sat, 21 May 2022 08:23:41 +0000

Author Names: ElHawary H.,Salimi A.,Gilardino M.S.

Database Source: Embase Weekly Updates

Journal Title: Annals of surgery

Article Title: Ethics of Facial Transplantation: The Effect of Psychological Trauma Associated With Facial Disfigurement on Risk Acceptance and Decision Making

Year: 2022

Issue: 5

Volume: 275

Abstract: OBJECTIVE: This study examines and contrasts the effect of risk disclosure on risk acceptance and perceived changes in quality of life (QoL) among individuals with and without facial disfigurement. SUMMARY OF BACKGROUND DATA: Psychological distress has been previously shown to alter patients' perception of certain treatments. Due to the grave risks and complications of FT, it is important to understand whether the psychological trauma associated with facial disfigurement alters their perception of FT and its associated risks. METHOD(S): Participants with and without facial disfigurement were recruited to complete a questionnaire about their perceived QoL, sense of identity, and willingness to proceed with FT in the context of 3 different hypothetical scenarios involving facial disfiguration. RESULT(S): Four hundred nine nonfacially disfigured and 74 facially disfigured participants were included. When both healthy and facially disfigured individuals were presented with the risks and benefits of a FT, they both perceived their QoL to be as low, or significantly lower, than if they had severe facial disfigurement. Furthermore, presenting the risks of FT significantly altered the decision making and risk acceptance of healthy individuals with no facial disfigurement. However, risk disclosure did not affect the decision making among facially disfigured individuals. CONCLUSION(S): This study highlights that presenting the complication profile of FT decreases risk acceptance of FT in healthy individuals but has no significant effects on facially disfigured individuals. The psychological impact of facial disfigurement and its influence on accepting the significant risks of FT should be considered and warrants further investigation. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.

THE ETHICAL AND LEGAL ASPECTS OF INFORMED CONSENT

Fri, 20 May 2022 08:26:22 +0000

Author Names: Majumdar R.K.,Majumdar A.

Database Source: Embase Daily Updates

Journal Title: European Journal of Molecular and Clinical Medicine

Article Title: THE ETHICAL AND LEGAL ASPECTS OF INFORMED CONSENT

Year: 2020

Issue: 8

Volume: 7

Abstract: Informed consent or the learned acquiescence is an important and underlying principle of bio-ethics. The specific character of the informed consent as it is in the present form has been due to it assuming a dominant and important character in the otherwise translational relationship between the patient and the doctor during the course of twentieth century. The earlier distinctive spirit of medicine as founded on the trust in physician's decision based upon the fact that "doctor knows best" has seen a steady decline resulting in a trust deficit and here upon, developing the doctrine of 'informed consent' wherein, the patient has been put in charge of his own care through the propagation and advancement of his own will and right to self determination as advocated in Article 21 of the Constitution. The current study is based upon critical analysis and doctrinal method. Copyright © 2020 Ubiquity Press. All rights reserved.

Ethical obligation and legal requirements: On informed consent practices in Bangladesh

Thu, 19 May 2022 00:00:00 +0000

Dev World Bioeth. 2022 May 19. doi: 10.1111/dewb.12356. Online ahead of print.

ABSTRACT

Informed consent to medical intervention is fundamental in both ethics and law. But in practice it is often not taken seriously in developing countries. This paper provides an appraisal of informed consent practices in Bangladesh. Following a review of the ethical and legal principles of informed consent, it assesses the degree to which doctors adhere to it in Bangladesh. Based on findings of non-compliance, it then investigates the reasons for such non-compliance through an appraisal of informed consent practices in Bangladesh and provides recommendations aimed at improving such practices. The significance of this paper lies in unveiling the interdependence between the ethical and legal traits of informed consent and their ramifications on strengthening the patient-oriented approach of duty to care.

PMID:35586924 | DOI:10.1111/dewb.12356

Erratum: Ethical procedures and patient consent differ in Europe (European Journal of Anaesthesiology (2015) 32 (126-131) DOI: 10.1097/EJA.0000000000000206)

Tue, 17 May 2022 08:27:48 +0000

Author Names: anonymous

Database Source: Embase Daily Updates

Journal Title: European Journal of Anaesthesiology,European Journal of Anaesthesiology

Article Title: Erratum: Ethical procedures and patient consent differ in Europe (European Journal of Anaesthesiology (2015) 32 (126-131) DOI: 10.1097/EJA.0000000000000206)

Year: 2015

Issue: 3

Volume: 32

Abstract: In the article,1 the authors wish to correct the final sentence of paragraph 2, page 127 from 'We had assumed that all ethical committees' processes would be based on research ethics guidelines such as the Nuremberg Code and the Helsinki Declaration, but we found that this is not the case.' to 'Basically, it was assumed that all committees' work is based on research ethics guidelines such as the Nuremberg Code and the Helsinki Declaration.' The original meaning of the sentence had been changed by the journal during the editing process. Copyright © European Society of Anaesthesiology.

Prediction of ethical decision making with professional values in senior nursing students

Mon, 16 May 2022 00:00:00 +0000

Perspect Psychiatr Care. 2022 May 16. doi: 10.1111/ppc.13112. Online ahead of print.

ABSTRACT

PURPOSE: This study investigated whether the professional values of nursing students can predict their ethical decision-making levels.

DESIGN AND METHODS: The study used a descriptive and cross-sectional research design. The study sample consisted of 130 senior nursing students. The data were collected from the Student Information Form, Nursing Professional Values Scale, and Nursing Dilemma Test (NDT). The data were evaluated using Pearson correlation analysis and multiple linear regression analysis.

FINDINGS: A significant correlation was found between students' professional values and their mean PLT total scores (p < 0.01). Also, a negative correlation was found between students' professional values and the total mean practical thinking scores (p < 0.01). Professional values of the students explained 21.2% of the total PLT score and 0.08% of the total practical thinking score.

CONCLUSION: The professional values of the students affect their principal and practical thinking skills in ethical dilemmas.

IMPLICATIONS FOR NURSING PRACTICE: It is recommended to discuss the ethical dilemmas observed or experienced by the students in their clinical practice in the field, increase the awareness of the students, and teach them how to deal with ethical dilemmas.

PMID:35575421 | DOI:10.1111/ppc.13112