Providing emergency medical care without consent: How the ‘emergency principle’ in Australian law protects against claims of trespass
Sam Boyle, Nikola Stepanov
Emergency Medicine Australasia, 24 March 2021
Abstract
In a medical emergency, the usual requirement to obtain consent before giving treatment does not apply. This exception to the general rule on consent to medical treatment is known as the ‘emergency principle’. By considering a case scenario, and by adjusting the facts to this scenario, we explain the circumstances in which the emergency principle will protect practitioners from an action in trespass. Although the fundamentals of this principle are uncontroversial, there are a number of uncertainties and inconsistencies in this law in relation to certain parameters. For example, whether a practitioner would ever be obliged to seek consent from a substitute decision‐maker before providing emergency treatment is not clearly or consistently explained. We suggest the law should be clarified.
Informed Consent in the Health Care System: An Overview from a Dental Perspective in Saudi Arabia
Informed Consent in the Health Care System: An Overview from a Dental Perspective in Saudi Arabia
Review Article
Nassar A.A., Demyati A.K.
Saudi Journal of Health Systems Research, March 2021; 1 pp 11–15
Open Access
Abstract
Background
Patient autonomy in the health care system is achieved by the vital principle of providing informed consent. Throughout history, informed consent gained recognition and improved to include more aids and steps to formalize and standardize the process of obtaining proper consent in medical and dental practice. Regardless of the type of informed consent obtained before the treatment, it should include an adequate understandable description of nature and diagnosis of the disease, treatment plan, proper alternatives, risks, and limitations.
Summary
There is limited information in the ethics literature covering critical concepts related to different dental procedures in Saudi Arabia. In Saudi Arabia, informed consent in dentistry is not well-documented. As everything is evolving and changing in Saudi society, litigation has progressed and impacted dentistry. This overview will help in addressing aspects related to informed consent and closing the gaps in the dental health care system in Saudi Arabia, managing complex ethical issues associated with dental patients. In addition, providing recommendations and shedding some light on the importance of informed consent will improve the situation of the informed consent process in Saudi Arabia.
Key Messages
Informed consent allows patients to be part of the decision-making process, and it provides legal protection for the practitioners from practice lawsuit cases. Dentists should take extra care in documenting the consent process and patient’s choice regarding their treatment to avoid unfavorable consequences. In Saudi Arabia, attention should be drawn toward the crucial role of informed consent, and more studies should be published in order to enrich the knowledge and to improve the health care system.
Understanding Exception from Informed Consent in Planned Emergency Research
Understanding Exception from Informed Consent in Planned Emergency Research
Understanding Research
CourtneyEdwards, Kimberly D. Johnson
Journal of Emergency Nursing, 11 March 2021
Abstract
Many of the current accepted treatment practices provided to patients in the first critical hour after a traumatic injury, stroke, or cardiac arrest have not been rigorously tested in clinical research trials. The inability to obtain informed consent is often a barrier to research in emergency, time-sensitive situations in which the patient is not able to provide informed consent nor is their family member immediately available to provide consent on behalf of the patient. Planned emergency research, often with exception from informed consent, is a type of research study that involves a patient with a life-threatening medical condition that requires urgent interventions, wherein the current treatments may be unproven or suboptimal, and who, because of their current condition, is unable to provide informed consent. This article summarizes the necessary components for using exception from informed consent in planned emergency research. Understanding the research design, particularly research processes specific to time-critical emergency situations, will ensure that the care provided by stretcher-side emergency nurses will result in optimal patient outcomes and is an integral aspect of emergency nursing practice.
Are we undermining the value of palliative care through advanced cancer clinical trial consent language?
Are we undermining the value of palliative care through advanced cancer clinical trial consent language?
Commentary
Puja J. Umaretiya, Jennifer P. Rubin, Jennifer M. Snaman, Christina Ullrich, Angela M. Feraco, Veronica Dussel, Joanne Wolfe, Elisha Waldman
Cancer, 10 March 2021
Abstract
Informed consents for advanced cancer trials contain language that misrepresents palliative care as an alternative to trial participation. This language should be revised to highlight that palliative care is appropriate at any point in the illness trajectory and alongside disease‐directed therapy.
[Expert consensus on informed consent for vaccination (part two)]
[Expert consensus on informed consent for vaccination (part two)]
Zhonghua Liu Xing Bing Xue Za Zhi
Chinese Preventive Medicine Association, 1 March 2021; 42(3) pp 369-399
Abstract
The Vaccine Administration Law of the People’s Republic of China and other relevant laws require that vaccine recipients or their guardians be educated about vaccines and how they work, and described in general the methods and contents of such vaccination education. With the new law and “Standard Operational Procedures for Immunization” as foundation documents, and in consultation with experts at home and abroad, the Chinese Preventive Medicine Association developed a consensus statement about informed consent for vaccination. This consensus statement is written for disease control and prevention health care personnel in vaccination services and describes the educational content of informed consent, a theoretical framework for immunization and immunization knowledge, the informed consent processes, principles of planning for vaccination, and an informed consent form. Part Two of the consensus includes influenza vaccine, pneumococcal vaccine, haemophilus influenzae type b containing vaccine, enterovirus type 71 inactivated vaccine, rotavirus vaccine, varicella attenuated live vaccine, herpes-zoster vaccine, human papillomavirus vaccine, rabies vaccine, hemorrhagic fever with renal syndrome vaccine, leptospira vaccine, anthrax vaccine, hepatitis E vaccine, cholera vaccine, typhoid vaccine, and tick-borne encephalitis vaccine.
Editor’s Note: This is a Chinese language publication
The advantages of nurse-led consent for dialysis in improving shared decision-making and obtaining legal consent
The advantages of nurse-led consent for dialysis in improving shared decision-making and obtaining legal consent
Jo-Anne Moodie, Elaine Sanders, Brett Sobey, Jade Ryan, Jayne Amy, Jenny Beavis, Adele Montgomery, Stephen G Holt
Renal Society of Australasia Journal, March 2021; 17(1) pp 4-9
Abstract
The treatment/medical consent procedure has generally been performed by doctors. Despite the recognised importance of the consent process, formal initial consent for maintenance dialysis was poorly performed at in our service and rarely performed thereafter. As a large renal unit with a commitment to excellence in patient care, we felt this was out of keeping with our remit and sought to change the process to ensure we delivered useful information to allow our patients to have a meaningful discussion around consent issues. We trained senior nurses to perform the reconsent process, and took the opportunity to reassess patients’ decision-making competence, discuss advance care planning, blood consent and personal data privacy issues. We demonstrated a large improvement in the number of patients having a valid dialysis consent form, and realised the potential of this procedure to improve the care we give to our patient group. We recommend the benefits of nurse-led consent for dialysis to other services.
Online Extremism and Terrorism Research Ethics: Researcher Safety, Informed Consent, and the Need for Tailored Guidelines
Online Extremism and Terrorism Research Ethics: Researcher Safety, Informed Consent, and the Need for Tailored Guidelines
Maura Conway
Terrorism and Political Warfare, 24 March 2021; 33(2) pp 367-380
Abstract
This article reflects on two core issues of human subjects’ research ethics and how they play out for online extremism and terrorism researchers. Medical research ethics, on which social science research ethics are based, centers the protection of research subjects, but what of the protection of researchers? Greater attention to researcher safety, including online security and privacy and mental and emotional wellbeing, is called for herein. Researching hostile or dangerous communities does not, on the other hand, exempt us from our responsibilities to protect our research subjects, which is generally ensured via informed consent. This is complicated in data-intensive research settings, especially with the former type of communities, however. Also grappled with in this article therefore are the pros and cons of waived consent and deception and the allied issue of prevention of harm to subjects in online extremism and terrorism research. The best path forward it is argued—besides talking through the diversity of ethical issues arising in online extremism and terrorism research and committing our thinking and decision-making around them to paper to a much greater extent than we have done to-date—may be development of ethics guidelines tailored to our sub-field.
Written Informed Consent-Translating into Plain Language. A Pilot Study
Written Informed Consent-Translating into Plain Language. A Pilot Study
Agnieszka Zimmermann, Anna Pilarska, Aleksandra Gaworska-Krzemińska, Jerzy Jankau, Marsha N Cohen
Healthcare, 20 February 2021; 9(2)
Open Access
Abstract
Background
Informed consent is important in clinical practice, as a person’s written consent is required prior to many medical interventions. Many informed consent forms fail to communicate simply and clearly. The aim of our study was to create an easy-to-understand form.
Methods
Our assessment of a Polish-language plastic surgery informed consent form used the Polish-language comprehension analysis program (jasnopis.pl, SWPS University) to assess the readability of texts written for people of various education levels; and this enabled us to modify the form by shortening sentences and simplifying words. The form was re-assessed with the same software and subsequently given to 160 adult volunteers to assess the revised form’s degree of difficulty or readability.
Results
The first software analysis found the language was suitable for people with a university degree or higher education, and after revision and re-assessment became suitable for persons with 4-6 years of primary school education and above. Most study participants also assessed the form as completely comprehensible.
Conclusions
There are significant benefits possible for patients and practitioners by improving the comprehensibility of written informed consent forms.
The Case for Consent Pluralism
The Case for Consent Pluralism
Jessica Keiser
Journal of Ethics and Social Philosophy, 2021
Abstract
A longstanding debate regarding the nature of consent has marked a tri-fold division among philosophical and legal theorists according to whether they take consent to be a type of mental state, a form of behaviour, or some hybrid of the two. Theorists on all sides acknowledge that ordinary language cannot serve as a guide to resolving this ontological question, given the polysemy of the word “consent” in ordinary language. Similar observations have been noted about the function of consent in the law and use of the word “consent” in legal contexts. This paper makes a parallel argument regarding consent’s characteristic normative role: roughly, to transform moral prohibitions into permissions. This role is neither unique nor essential to any one particular kind of thing, be it a mental state, form of behaviour, or hybrid of the two—rather, it is played by mental states and behaviour in independent and context-sensitive ways. The upshot is that insofar as we are interested in its normative implications, we ought to adopt a pluralistic approach to consent which gives independent weight to the moral contributions of facts about mental states and facts about behaviour relative to a context.
Informed Consent: A Monthly Review
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March 2021
This digest aggregates and distills key content addressing informed consent from a broad spectrum of peer-reviewed journals and grey literature, and from various practice domains and organization types including international agencies, INGOs, governments, academic and research institutions, consortiums and collaborations, foundations, and commercial organizations. We acknowledge that this scope yields an indicative and not an exhaustive digest product.
Informed Consent: A Monthly Review is a service of the Center for Informed Consent Integrity, a program of the GE2P2 Global Foundation. The Foundation is solely responsible for its content. Comments and suggestions should be directed to:
Editor
Paige Fitzsimmons, MA
Associate Director, Center for Informed Consent Integrity
GE2P2 Global Foundation
paige.fitzsimmons@ge2p2global.org
PDF Version: GE2P2 Global_Informed Consent – A Monthly Review_March 2021
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