![]() ![]() Vulnerable research subjects, such as children and the cognitively or mentally impaired, require additional protection. Institutional review boards help guarantee the protection of human subjects. Consent of human subjects for participation in research requires that they fully understand their role and risks, not be coerced, and be allowed to withdraw at any time without penalty. Treatment may be provided in an emergency situation without consent if the treatment given represents the standard of emergency care. Older children and adolescents should be asked to provide their assent for treatment in addition to their parents' permission. Incompetent patients require surrogate decision makers to consent or refuse on their behalf. Informed consent is incorporated into a process of agreement between a patient and a physician called "shared decision making." The procedural requirements of informed consent vary as a function of the risks of the tests or treatments. A patient's informed consent requires adequate information, capacity to decide, and absence of coercion. Judicial review is a form of legal proceeding in England and Wales that enables an individual (a claimant) to ask the court (the Administrative Court, which is a specialist court within the Queen’s Bench Division of the High Court) to review a decision made by a public body (the defendant), ultimately with a view to having that decision quashed. Informed consent encompasses informed refusal, the correlative right of patients to refuse tests and therapies they do not want. ![]() Physicians have an ethical and legal duty to obtain patients' informed consent before ordering testing and treatment. ![]()
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