Informed Consent

Although adolescence and young adulthood are generally healthy times of life, several important public health and social problems either peak or start during these years (Healthy People, 2015). For this discussion, I selected the scenario involving an adolescent Hispanic/Latino boy living in a middle-class suburb. When performing the health history interview of an adolescent many factors must be considered. Practitioner must also keep an open mind and respect patient cultural beliefs and values. “Family, religious beliefs, communication, and health beliefs have been noted in the literature as important cultural influences for Hispanic patients” (Hicks, 2012). Obtaining parental consent prior to a one-on-one assessment with an adolescent

Informed consent is defined as the knowledgeable and voluntary agreement given by a patient. Informed consent protects patient autonomy and endorses trust between the medical community and the patient. If a patient knows that they are lied to, or not told the entire truth, the patient will lose confidence in the medical community as a whole (Eval, 2011). If this non-education does happen, then the patient will not be able to make choices about the end of their life, medially or financially (Piper, nd). Personal integrity is gained when informed consent is used, as the person is making their own choices, not having their family or others make choices on their behalf, when the patient is excluded for the education of the disease (Eval, 2011).

In the study “Assessing the quality of informed consent in a resource-limited setting: A cross-sectional study,” researchers investigated the process of obtaining informed consent in clinical and public health research. The method of the study utilized interviews, in which research participants were asked a series of questions after they had been through informed consent procedures. 600 participants were interviewed, and the results show that 5.9% believed that they were not given enough information before deciding to participate. Only 5.7% of the participants said that they had not signed a consent form before making the decision to participate. Interestingly, 33.7% reported that they were not aware of their power to withdraw from participation

The importance of reassuring children and young people that their information is confidential is that it makes them more likely to share their information and makes them more relaxed knowing they can trust the adults working in the school with their personal information.

I have undertaken paediatric informed consent training, which has equipped me with the skills to ensure that effective informed consent is obtained. I have also been involved in a MRHA inspection. My current role also includes working within research guidelines, including research governance, ethics, MRHA, and the human tissue act. I have a very good understanding of ethical issues, and I am both GCP and consent trained. Also within my role I liaise closely with centre nationally and

Faden and Beauchamp discuss two definitions of informed consent, which are labeled sense1 and sense2. First, sense1 informed consent is defined as “autonomous authorization”. (Vaughn, p. 191). The key aspect of sense1 is that the patient has the autonomy to consent, or refuse consent. Faden and Beauchamp state four defining characteristics of sense1 informed consent: complete understanding of the consent, individual desire for the consent, intent to consent, and authorizing consent. (Vaughn, p. 191).

Counselors must be aware of their ethical and legal obligations when providing counseling services, such as those related to crisis prevention and intervention. This knowledge can guide the counselor in making appropriate decisions to best assist the client. The American Counseling Association Code of Ethics (2014) provides counselors with the core principles of autonomy, nonmaleficence, beneficence, justice and fidelity to guide them in decisions making. Furthermore, the following ACA (2014) ethical codes are applicable to crisis counseling:

Informed consent is the agreement of a patient to undergo specific tests, procedures, treatments, and so forth; the disclosure of any risks and/or benefits of the treatment/procedure as well as any possible alternatives and the risks and/or benefits of such alternatives must be discussed by the healthcare professional to

Public Health England (2017) states that “Consent to treatment is the principle that a person must give permission before they receive any type of medical treatment, test or examination. This must be done on the basis of an explanation by a clinician”. Selinger (2009) also mentions that patient consent in required regardless of the procedure whether physical or something else as the consent principle is an important part of medical ethics and the international human rights. For example Mr Eric was asked several times and given time to think about the procedure which was going to take place and who was going to do it and the procedure was clearly explained to him to make an informed decision. British Journal of Medical Practitioners (Bjmp) (2017) recommends that consent must be voluntary, valid and informed, and the person consenting must have the capacity to make the decision. Therefore all health care professionals are required to provide treatment when patient has given consent voluntarily either consent or not to consent, given full information of the risks benefits and alternatives of the procedure

Informed consent is a common litmus test for many of the ethical issues. Participants in a study should be told the consequences.

The Health Care Consent Act (HCCA) sets out explicit rules and specifies when consent is required and who can give the consent when the client is incapable of doing so (College of Nurses of Ontario (CNO), 2009). According to the HCCA (1996), there is no minimum age for providing or refusing consent in Ontario. A person is capable if he or she understands the information given that is relevant to making a decision concerning the treatment, and can appreciate the anticipated consequences of both accepting or declining a treatment. (Keatings

Henrietta Lacks was an African American woman from the 1900s. She was diagnosed with cancer and had her cancer cells cultured without her consent. These cancer cell lines are known as HeLa cell lines and one of the first immortalized cell lines utilized in current medical research. The fundamental issue with Henrietta Lacks’ HeLa cells is that the researchers never obtained consent for the use of these cells; nevertheless, these cells have benefitted greatly for the area of research. Not only were the cells useful for finding treatments for diseases, but the cells were also utilized in space studies too. It was not until the scientists required DNA data from these cells that they sought out whose cells these belong to. After finding out that

Informed consent is an important part of patient autonomy.  Discuss how you inform your patient about implants and the potential risks / complications associated with implants.

In relation to the prevention of psychological harm, the children should have been immediately released after an allocated amount of time if no behaviour, distressed behaviour or aggressive behaviour was displayed. One of the child participants sat in the enclosure for a total of 15 minutes with no attempt of escaping (Bain et al, 1958). Therefore, if the study was to be conducted in 2016, after one minute of no activity, the child should be removed from the enclosure. Also, at the first sign of distress or discomfort the child should be immediately removed from the experiment and returned to their parents or caregiver and comforted until they are happy. Another ethical issue within the initial experiment was deception. To resolve this issue in 2016, the television in the playhouse should not be included at all as by the television turning off, this could have caused distress for the child as they may have expected it to continue playing. Therefore to avoid deception, there should be nothing within the playhouse that could distract the child or make them upset by having it turned off, such as the television. The children should be instructed or encouraged to go inside the blank playhouse and the only thing they should be able to do is escape the playhouse by means of pushing the door. In regards to gaining consent, the British Psychological Society state that

For instance, the practitioners are obligated to constantly inform the participants about plans that pertains to interventions (Reamer, 1987). In addition, it is essential for informed consent to include the following: “What is done, the reasons for doing it, clients must be capable of providing consent, they must have the right to refuse or withdraw consent, and their decisions must be based on adequate information” (Kirk & Wakefield, 1997, p. 275). One of the most dehumanizing incidents that occur is the researchers prohibit the participants’ self-determination. For example, the men were compliant with receiving treatment and to be examined by the physicians. However, the physicians did not reveal the actual purpose of the study. Consequently, penicillin was the most effective medication, but the doctors decided to withhold treatment (Bozeman, Hirsch, & Slade ,