Changes to Parental Consent Requirements for Abortion in Massachusetts and Impact on Timeliness of Care for Adolescents Aged 16 to 17 Years
Isabel Fulcher, Kara Kimball, Zarah Rosen, Jennifer Fortin, Namita Arunkumar, Danielle Gelfand, Elizabeth Janiak, Luu Ireland
American Journal of Public Health, March 2025
Abstract
Objectives
To measure the effect of the ROE Act, which eliminated parental consent requirements for abortion for individuals ages 16 to 17 years, on abortion timing for adolescents in this age group in Massachusetts.
Methods
The primary outcome was gestational duration at abortion for individuals aged 16 to 19 years at Planned Parenthood League of Massachusetts from 2017 to 2022. Our control group included abortions among those aged 18 to 19 years. In our primary analysis, we used a comparative interrupted time series with a linear model to capture temporal trends, seasonality, whether an abortion was undergone during the acute phase of the COVID-19 pandemic, previous abortion, and race/ethnicity categories.
Results
Minors aged 16 to 17 years underwent 749 abortions during the study. Individuals aged 18 to 19 years underwent 2773 abortions. The ROE Act resulted in a 5.46-day decrease in gestational duration at abortion among minors (95% confidence interval = −11.82, 0.91).
Conclusions
Removal of the parental involvement requirement for adolescents aged 16 to 17 years in Massachusetts led to minors undergoing abortions at earlier gestational durations, highlighting the importance of potential impacts of similar legislation to decrease barriers to abortion access for minors.

A Critical Appraisal of Informed Consent in English Medical Law: A Patient-Centred Approach Against Medical Paternalism: Who Gets to Decide What Is Best for Me?
Lisa Kachina Poku
European Journal of Health Law, 18 February 2025
Abstract
This article seeks to discuss informed consent in English law. The attitudes on informed consent have shifted to a more patient-centred approach following Montgomery v Lanarkshire Health Board [2015] UKSC 11, [2015] AC 1430, as opposed to the long-standing Bolam decision where clinical judgment was more widely accepted. Thus, following on from the decision in Montgomery a patient is required to know about material risks regarding the proposed treatment and not what the doctor thinks would be the best practice as has been the long-standing consensus since Bolam was decided back in 1957 with subsequent cases following suit. The Montgomery principle has allowed more transparency in the patient–doctor relationship, allowing for a discussion between the doctor and the patient to be the central focus. The outcome of Montgomery was a much needed change in healthcare because prior to this it could be seen that patients were having decisions made on their behalf, and if they had been informed accordingly regarding the risks involved may have decided not to go ahead with the procedure. In the case of Diamond v Royal Devon & Exeter NHS Foundation Trust [2019] EWCA Civ 585 the case highlights the issue of causation in medical negligence action if a doctor does not warn of risks and advise treatment alternatives this would not result in a claim for damages because the patient in this case as was held would have gone ahead with the mesh repair in any case, and thus failing to establish causation could result in no remedy as it did in Diamond. Furthermore, the recent case of McCulloch and others v Forth Valley Health Board [2023] UKSC 26 adds a bit of salt to the wounds of those who had thought or believed that Montgomery had already clarified the position regarding disclosure of alternative treatments to a patient, and to our dismay to learn of that once again English courts have ruled in favour of ‘Bolam’.

Informed consent in neurosurgery with particular reference to alternatives to proposed surgery. Updated case law including McCulloch.
Research Article
Nicholas Todd, James Wright-Todd
Medico-Legal Journal, 11 February 2025
Abstract
Introduction
Informed consent is a crucial element in neurosurgical practice; failures of the consenting process are a common cause of litigation in neurosurgery and judgments that have particular relevance to neurosurgical practice will be reviewed here. Guidance for consent based upon current case law is discussed.
Methods
The legal databases BAILII and WestLaw were searched using the search term “informed consent”. The BAILII search yielded 86 abstracts, WestLaw yielded 33. There were 15 duplicates. Ten of the remaining 104 abstracts were commentaries, leaving 94 judgments. From those judgments a further 21 cases were added. A total of 115 judgments were reviewed by both authors.
Results
A total of 23 judgments dealing with issues of informed consent in neurosurgical and other surgical practice were selected. The cases and their implications for neurosurgical consent are discussed below.
Discussion
When proposing a surgical procedure to a competent adult, the treating surgeon must discuss the benefits, risks and alternatives to treatment with the patient. The surgeon can be guided by professional guidance from the GMC, or another professional body, and/or case law. Relevant issues include: (i) the risks and benefits of surgery; (ii) information that is accurate (or inaccurate, incorrect, missing or late information); (iii) established practice; (iv) the current state of knowledge; (v) reasonable alternative treatments; and (vi) surgery performed on a different day or by a different surgeon.

Perceptions and experiences of healthcare professionals of implementing the Organ Donation (Deemed Consent) Act in England during the Covid-19 pandemic
Research
Mustafa Al-Haboubi, Leah McLaughlin, Lorraine Williams, Jane Noyes, Stephen O’Neill, Paul Boadu, Jennifer Bostock, Nicholas Mays
BMC Health Services Research, 31 January 2025
Open Access
Abstract
Context
In May 2020 during the COVID-19 pandemic, England implemented a ‘soft’ opt-out system of consent to deceased organ donation. As part of a wider evaluation, this analysis focused on the perceptions of health care professionals, specifically their experiences of implementation.
Methods
Mixed-methods study informed by Normalisation Process Theory, based on two national surveys of health care professionals and interviews, observations and document analysis, across two case study sites. Routine NHS Blood and Transplant’s audit data provided context.
Findings
70 interviews with 59 staff and 244 first and 738 second surveys. COVID-19 affected every aspect of implementation. Although supportive in principle, many staff were unconvinced that legislative changes alone would increase consent rates. Many staff were redeployed or left their jobs. As a result, staff were not able to work collectively as intended for implementation. Staff received routine donor audit data suggesting the law was yet to make a difference to consent rates, reducing their enthusiasm and commitment.
Conclusions
Implementation could have been more impactful if delayed. The National Health Service needs to reprioritise organ donation and relaunch the implementation plan in the post-pandemic period, though it is unlikely the changes will bring about a significant increase in consent rates.

The legal requirements for patient consent in Poland: A survey of doctors’ level of knowledge
Kamila Kocańda, Zbigniew Siudak, Michał Chrobot
Journal of Forensic and Legal Medicine, January 2025
Abstract
The legality of providing any medical intervention needs to be guarded by the requirement of a conscious and informed consent given by the patient. The legal requirements of granting such a consent in practice should apply not only to typical situations, when the patient is able to manifest his medical decision consciously, but also to more complicated cases where a patient cannot provide such a consent himself by the time the provision of service is given. This implies the need for the doctor to take actions specified by law, such as, but not limited to obtaining the consent of the guardianship court or intervene without the consent. The purpose of this study was to determine the level of knowledge of the currently in force Polish statutory requirements for legitimizing medical decisions in the relationships between physicians and patients. The study used anonymous surveys designed by the authors for the purpose of this study to test the level of knowledge of legal requirements regarding the principles under which patients provide consent to healthcare services and was conducted in two hospitals in Poland and Polish medical university. The survey results indicated that respondents do not possess sufficient understanding of the legal requirements for legitimizing acts or omissions of the physicians in the diagnostic and therapeutic process.

Towards Equitable Healthcare: Redesigning Informed Consent Regulations
Rohmad Imam Masyuri, Didiet Setioboedi, Anis Mashdurohatun, Dhiwangkoro Aji Kadarmo, Nur Fareha
Journal of Ecohumanism, 22 December 2024; 3(8)
Abstract
Informed consent is a fundamental element of ethical and legal healthcare practices, serving as a cornerstone for patient autonomy and equitable care. In Indonesia, informed consent is regulated under frameworks such as Law No. 17 of 2023 on Health, Government Regulation No. 28 of 2024, and Ministerial Regulation No. 290 of 2008. While these regulations establish foundational guidelines, they are limited in addressing contemporary challenges, particularly in the communication of medical information tailored to diverse patient needs. This article examines the gaps in the current regulatory framework, particularly regarding the inadequacies in ensuring patient understanding and participation in medical decision-making. The analysis highlights key shortcomings, including the lack of detailed technical provisions for adapting information delivery to various patient conditions, such as those with disabilities, language barriers, or limited literacy. It argues that these gaps undermine the principles of equity and justice, potentially resulting in consent that does not reflect informed patient choice. To address these challenges, the article proposes regulatory reconstructions emphasizing justice, transparency, and inclusivity. Suggested reforms include the mandatory use of digital documentation, enhanced communication technologies, and support systems such as translators or visual aids for vulnerable populations. By integrating these reforms into the legal framework, the healthcare system can foster a more inclusive informed consent process, enhancing patient trust, autonomy, and equity in medical decision-making. These changes are crucial for bridging the gap between ethical theory and practical application in Indonesia’s evolving healthcare landscape.

Ethical Issues in Vaccination: Balancing Public Health and Individual Autonomy
Ledia Qatipi, Albana Fico, Gentian Vyshka
Current Research in Medical Sciences, December 2024; 3(4)
Abstract
Vaccination has been one of the most successful public health interventions, contributing significantly to the prevention of numerous infectious diseases and saving countless lives. However, its implementation has not been without ethical challenges. This paper examines key ethical issues related to vaccination, considering the tension between public health goals and individual autonomy. Through an exploration of informed consent, distribution equity, vaccine mandates, and misinformation, this paper aims to provide a comprehensive analysis of the complex ethical landscape in the realm of vaccination.

Vulnerability in research ethics: A call for assessing vulnerability and implementing protections
Michael G Findley, Faten Ghosn, Sara J Lowe
Proceedings of the National Academy of Sciences of the United States of America, 20 August 2024
Abstract
Ethics standards reference the need for special consideration of vulnerable populations, such as pregnant women, incarcerated individuals, and minors. The concept of vulnerability is poorly conceptualized in the medical sciences where it originated, and its application to the social sciences is even more challenging. Social science researchers may unwittingly fail to appreciate preexisting vulnerabilities and indeed may be responsible for inducing new research-related vulnerability. In this paper, we present the first comprehensive coding of country-level vulnerability designations. Specifically, we coded all 355 official documents governing social/behavioral human subjects research for the 107 countries with such regulations and identified 68 distinct vulnerability categories. The data reveal substantial regional variation, overemphasis of categories derived from medical sciences, neglect of critical categories such as displacement, and likely heterogeneity within and across groups. The article provides a conceptual framework that shifts the problem away from static, enumerated categories toward emphasis on research-induced vulnerability. Based on our conceptualization and coding, we present a framework for assessing vulnerability and implementing appropriate protections.