Dissertations / Theses on the topic 'Medical consent'
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1
Baker, Eileen F. "Autonomy and Informed Consent." Bowling Green State University / OhioLINK, 2017. http://rave.ohiolink.edu/etdc/view?acc_num=bgsu1491391673593916.
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Maclean, Alasdair Rhuairidh. "Consent to medical treatment and the competent adult." Thesis, University of Glasgow, 2006. http://theses.gla.ac.uk/5448/.
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In this thesis I analyse the concept of consent to medical treatment. I explore its ethical basis in autonomy and examine how other principles and ethical approaches might interact with the rules derived from autonomy. I then situate the relevant ethical obligations within the context f the healthcare professional-patient relationship which subsequently allows me to develop a textured model of consent. The model is predicated on the theory that consent is a secondary right, derivative on the underlying right which it controls. By giving or withholding consent, the autonomous person determines who may justifiably infringe the primary right. Importantly, however, the context of the professional-patent relationship highlights the relevance of consent, not just as permission, but also as agreement. I subsequently utilise the model of consent to analyse the current law, which is found to be deficient. I explore the conceptual difficulties of the split regulation between the torts of battery and negligence. I examine the current standard of disclosure and conclude that while it seems to be moving towards more autonomy respecting prudent patient standard, the courts may still be affording expert witnesses too much say in determining which risks should be disclosed. Most importantly I expose the thin and unsatisfactory conception of autonomy that appears to ground the current legal approach. Some of the common law’s deficiencies lie in tort law’s focus on the outcome rather than the process of the interaction between healthcare professional and the patient. There are three responses to these deficiencies. The common law could be allowed to continue its piecemeal development. The deficiencies of the common law could be patched up by developing professional regulation, or new legislation could be drafted to deal specifically with consent to medical treatment. If there is a genuine commitment to patient autonomy and patient centred care then I submit that legislation is justified.
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McLean, Sheila Ann Manson. "Information disclosure, consent to medical treatment and the law." Thesis, University of Glasgow, 1987. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.298800.
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Heywood, Robert James. "The law and practice of consent to medical intervention." Thesis, Sheffield Hallam University, 2006. http://shura.shu.ac.uk/3197/.
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This thesis explores the challenging concept of informed consent. It is an empirical study investigated in a medico-legal context. The research combines the use of quantitative and qualitative research methods to analyse the different views of the parties who are actively involved in the consent process in both medical and legal settings. The project provides a comprehensive review of the literature concerning the legal aspects of consent and information disclosure, critically analysing relevant case law and academic opinion. The problematic areas are highlighted and from these a number of research areas are identified forming the basis of the empirical inquiry. The thesis is then broken down into a number of individual studies incorporating a range of empirical techniques. These include: - A quantitative study employing a questionnaire to evaluate medical students' knowledge and to identify what is important to them in respect of consent.
- A qualitative interview study exploring health care professionals' opinions on consent in primary care.
- A qualitative interview study exploring health care professionals' opinions on consent in secondary care.
- A qualitative interview study exploring patients' perspectives on consent.
- A qualitative observational study to assess how consent procedures operate in practice in secondary care.
- A qualitative interview study exploring consent litigation in practice from solicitors' perspectives.
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Hoeyer, Klaus. "Biobanks and informed consent : An anthropological contribution to medical ethics." Doctoral thesis, Umeå universitet, Institutionen för folkhälsa och klinisk medicin, 2004. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-358.
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Background: 1985 saw the beginnings of a population-based biobank in Västerbotten County, Sweden. In 1999, a start-up genomics company, UmanGenomics, obtained ‘all commercial rights’ to the biobank. The company introduced an ethics policy, which was well received in prestigious journals, focusing on public oversight and informed consent. Aims: To explore how social anthropology can aid understanding of the challenges posed by the new role of the biobank in Västerbotten, and thus complement more established traditions in the field of medical ethics. An anthropological study of the ethics policy was executed. Theoretical perspective: Inspired by the anthropology of policy and social science perspectives on ethics and morality, the policy was studied at three analytical levels: policymakers (who formulate the policy), policy workers (who implement the policy, primarily nurses who obtain informed consent) and target group (for whom and on whom the policy is supposed to work: the potential donors to the biobank). Methods: Policymakers, nurses, and potential donors were interviewed, donations observed, and official documents analysed to mirror the moral problematizations made at the three levels in each other and to study the practical implications of the policy. To extend the reliability of the findings two surveys were executed: one among the general population, one among donors. Results: The qualitative studies show that policymakers distinguish between blood and data differently to potential donors. Informed consent seems more important to policymakers than potential donors, who are more concerned about political implications at a societal level. Among the respondents from the survey in the general public, a majority (66.8%) accepted surrogate decisions by Research Ethics Committees; a minority (4 %) stated informed consent as a principal concern; and genetic research based on biobank material was generally accepted (71%). Among the respondents to the survey in donors, 65% knew they had consented to donate a blood sample, and 32% knew they could withdraw their consent; 6% were dissatisfied with the information they had received; and 85% accepted surrogate decisions by Research Ethics Committees. Discussion: The ethics policy constitutes a particular naming and framing of moral problems in biobank-based research which overemphasises the need for informed consent, and underemphasises other concerns of potential donors. This embodies a political transformation where access to stored blood and medical information is negotiated in ethical terms, while it also has unacknowledged political implications. In particular, the relations between authorities and citizens in the Swedish welfare state are apparently transforming: from mutual obligation to individual contracts. Conclusion: Anthropology contributes to medical ethics with increased awareness of the practical implications of particular research ethical initiatives. This awareness promotes appreciation of the political implications of ethics policies and raises new issues for further consideration.
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Hoeyer, Klaus Lindgaard. "Biobanks and informed consent : an anthropological contribution to medical ethics /." Umeå : Univ, 2004. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-358.
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Devereux, John Anthony. "Competence to consent to medical treatment in England and Australia." Thesis, University of Oxford, 1993. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.358468.
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Barit, Avi. "The doctrine of informed consent in South African medical law." Diss., University of Pretoria, 2017. http://hdl.handle.net/2263/60104.
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Walker, Nancy L. Hamilton. "The relationship between patient perceptions of informed consent and recall of information received during the informed consent process." Virtual Press, 1993. http://liblink.bsu.edu/uhtbin/catkey/865959.
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Informed consent is a requirement by law. Informed consent is a two part process: giving the patient sufficient information so that an educated choice can be made and obtaining assent in writing (Coy, 1989; Fiesta 1991; Sweeney, 1991;). The purpose of this study is to determine the ability to recall information and the perception of patients about the process of receiving information after signing a consent to participate in a large research trial. Patients signing consents for participation in the Breast Cancer Prevention Trial were asked to complete the surveys. Thirty three patients were asked to complete the questionnaires. Twenty - four (72%) of the respondents returned the completed questionnaires. Confidentiality will be maintained since no names or identifying markers will be used.A modified Patient Recall Survey (Casselith, Zupkis, Sutton - Smith, & March, 1980) and a modified Consent Form Survey (Casselith et al, 1980) were used. The significance of the study is that the results will assist in improving the type of information given to patients and how that information is provided. By increasing patients awareness about the need for and rights of giving informed consent patients will be more knowledgeable health care consumers. Imogene King(1981) provides the theoretical framework for this study using the concept of perceptions as the basis.The first research question illustrated that the majority of the respondents were able to recall at least three risks or complications of participation in the Breast Cancer Prevention Trial. The second research question revealed eighty - seven percent of the patients agreed that informed consents are necessary. However, 27.8 % of the respondents perceived the informed consent as a legal document to protect the physician rights, while only 19.6 % felt that the consent represented a legal document to protect patient rights. Eighty three percent of the respondents understood that a consent did not have to be signed. However, responses to a second question revealed only 21.3 % understood that the informed consent was a chance to refuse or change treatment. Results to research question 3 illustrated that patients felt that informed consents are necessary. Finally, 79.2 % of patients reported that nurses provided the majority of informed consent information. When patients are able to understand and participate in health care decisions, patients will feel more control in determining outcomes.School of Nursing
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Morin, Sophie. "La place des droits du patient à l'intérieur de la conception actuelle de l'obligation de renseigner en matière médicale /." Thesis, McGill University, 1999. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=30319.
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This thesis deals with the concept of the medical duty to inform focusing on the rights of the patient. It emerges that the notions governing medical responsibility do not adequately address the question of the protection and application of the rights of the patient. Existing conceptions of the notions of dereliction, causality and damage are analysed in order to point out the many inadequacies with the rights of the patient, source of the obligation to inform. Particular emphasis is given to the situation in Quebec and to the eventual place that could be occupied by conception of the duty to inform that is more sensitive to the situation and rights of the patient.
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O'Regan, Karla Maureen. "Beyond illusion : a juridical genealogy of consent in criminal and medical law." Thesis, London School of Economics and Political Science (University of London), 2014. http://etheses.lse.ac.uk/934/.
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Consent is a concept used frequently and with great significance in a wide array of legal fields. It serves to regulate relationships, legitimize authority, delimit normality, and entrench idealized ways of being in the world. Yet despite the consequence of these functions, there is very little precision within legal scholarship about just what consent is. Few investigations of its definitional content depart from presumptive statements about personal autonomy. These associations are often described as the ‘common sense’ of consent and serve to secure a foundationalist discourse about what consent is, rendering alternative conceptions of its meaning or functions unintelligible. This is perhaps best evidenced in more critical approaches to consent, where despite widespread acknowledgement of the concept as a legal and political fiction, its status as a signifier of autonomy is maintained. This creates an imperative to move beyond the notion of consent as merely an illusion, to an understanding of it as something more operative. Not only does the story of autonomy that is told about consent obscure the social realities of inequality, difference, and subordination that might threaten a notion of a homogenous citizenry (and thus, governmental action made in its name), but it also conceals the historically specific conditions of existence which have brought consent’s ‘common sense’ story of autonomy into being. This thesis explores how this dominant narrative of consent, while producing certain ‘ideal’ subjectivities, also necessarily produces subjectivities which don’t fall within the ambit of consent. Moreover, this project asks what is achieved when the meaning of consent is positioned as a matter of ‘common sense’? What does its apparent transparency keep obscure? In contrast to conventional approaches to consent, this project positions consent as an historical artefact rather than a concept with doctrinal, cognitive, or communicative certainty and seeks to investigate its operations across legal fields rather than strictly within them. This includes an examination of consent to sex, the doctrine of informed consent in medical jurisprudence, and the defence of consent to assault in professional sporting contexts. Further, the project engages in a ‘juridical genealogy’ of consent, studying its use in three vastly different historical periods in search of how it might perform different socio-political functions than understandings of its role within contemporary medical and criminal law suggest it should. How these counter-narratives of consent serve to challenge the dominant autonomy story are investigated for what they reveal about the frames of cultural and legal intelligibility at work in consent law today.
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Lyons, Barry. "'Who is silent gives consent' : power and medical decision-making for children." Thesis, University of Manchester, 2011. https://www.research.manchester.ac.uk/portal/en/theses/who-is-silent-gives-consent-power-and-medical-decisionmaking-for-children(1860645d-78f2-4b89-9524-e32e1b5fa21e).html.
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This thesis seeks to examine how healthcare decisions are made for children, with a particular focus on situations where medical interventions that (1) are not intended to advance the medical welfare of the individual child (eg bone marrow donation and research without therapeutic intent involving young children), or (2) are contrary to the expressed will of the child (e.g. the imposition of life-saving treatment on adolescents who have refused it), are authorised by parents or the state. The authorisation of these procedures is contentious because they breach the child’s bodily integrity while either (a) lacking a clear therapeutic purpose with regard to that child, or (b) being imposed even though refused by a possibly competent adolescent. Their controversial nature has lead to attempts to justify these procedures, generally by the application of ideal-type adult-child relationship theories. The four papers at the core of this thesis examine these legitimising propositions, but demonstrate that they are insufficiently robust to legitimise the acts in question. Instead, this thesis raises questions about inequality; about why it is deemed acceptable to take the tissue of the vulnerable incompetent but not the capable adult; or why it is appropriate to impose different tests of mental capacity on the adolescent and the adult, or of competence on the ‘criminal’ child and ‘innocent’ teenager. It is proposed that the reason that inequitable treatment can occur is because adults sit in a position of power and authority relative to children. The common themes in all four papers are thus the issues of power, inequality and fairness. There is also a focus on the use of language, and it is argued that terms are used in academic debate about children’s healthcare issues that lead to a lack of clarity and transparency in discussions about the imposition of unchosen healthcare burdens on vulnerable populations. If we hold that children are morally relevant beings deserving of respect then debates about matters that concern them should take place using language that avoids obfuscation and the cloaking of adult interests.
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Bourne, Katie. "Determining capacity to consent in people with learning disabilities." Thesis, n.p, 2000. http://ethos.bl.uk/.
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Plant, Nigel. "The interaction achievement of consent for medical examinations and investigations by healthcare professionals." Thesis, University of Nottingham, 2008. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.493338.
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Consent has gained an increasing innportance in both health care policy and practice. Research in this subject has focused on information needs of patients (McKeague and Windsor, 2003), and their understanding of information (Turner and Williams 2002). There has been little or no consideration as to how the health professional interactionally seeks the patients consent.
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Vaswani, Nileema Ajit. "The role of informed consent in the ethics of medical research on humans." Thesis, University of London, 2004. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.405938.
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Cai, Yinghong. "The legal rights in informed consent form for treatment in China." View the Table of Contents & Abstract, 2007. http://sunzi.lib.hku.hk/hkuto/record/B38478730.
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Lashley, Myrna. "Informed proxy consent : communication between surgeons and surrogates about surgery." Thesis, McGill University, 1995. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=29068.
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Professionals whose job it is to counsel patients must be cognizant of the role played by communication in the establishment of a trusting working relationship. This is no less true for those within the medical community who must obtain informed consent for surgical interventions than it is for those working within the area of mental health. In order to determine what role communication plays in the obtaining of informed consent within a pediatrics setting, a qualitative study was conducted of 20 surrogates (those individuals giving consent on behalf of legally incompetent children) and of 5 surgeons performing surgical interventions on those children. Two sets of questionnaires were administered in order to elicit information pertaining to how surgeons communicate information to surrogates and to investigate how that information is received and processed by the surrogate. Results showed that while the obtaining of signed informed consent itself may not be a major problem, there are some difficulties in the communication between surgeons and surrogates in this domain. Based on the findings, recommendations for improved communication between surgeons and surrogates are proposed.
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Gibb, Winna. "Informed consent : a liberal perspective." Thesis, Queensland University of Technology, 1998.
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Pease-Carter, Cheyenne Minton Casey Barrio. "Preferences among student counselors regarding informed consent practices within counselor education." [Denton, Tex.] : University of North Texas, 2008. http://digital.library.unt.edu/permalink/meta-dc-6066.
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Anthony, John. "The justfiable limitations of patient autonomy in contemporary South African medical practice." Thesis, Stellenbosch : University of Stellenbosch, 2009. http://hdl.handle.net/10019.1/2859.
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Thesis (MPhil (Philosophy))--University of Stellenbosch, 2009.ABSTRACT: The European Enlightenment secured man’s freedom from doctrinal thought. Scientific progress and technological innovation flourished in the 18th Century, radically changing the lives of all. Man’s mastery and transformation of his environment was matched by revolutionary political reform, resulting in the dissolution of empire and the transfer of power into the hands of the people. Social transformation saw the city-states of pre-modern man supplanted by a globalized community whose existence grew from time and space distantiation facilitated by the new technologies and the development of symbolic forms. These sweeping social, political and ideological changes of the 18th Century fostered the belief that man’s transformative authority was indeed his to command. Man believed he had a right to self-governance and to autonomous decision-making. Kant described moral autonomy as the freedom men have to show rational accountability for their actions and he saw in men a dignity beyond all price because of this moral autonomy. Personal autonomy is seen as the expression of the free will of individuals and is justifiably constrained by the need to respect the interests and agency of others. The principle of autonomy, in the context of medical practice, was not clearly articulated until the early 20th century. Prior to this, the ethical practice of medicine relied upon the beneficent intentions of the practitioners. The limits to patient autonomy have been delineated largely by issues of social justice based upon the need to share scarce resources fairly among members of society. However, autonomy remains a dominant principle and is most clearly exemplified by the process of informed consent obtained prior to any medical intervention. This thesis provides a conceptual analysis of autonomy in the context of informed consent. Following this, several different clinical scenarios are examined for evidence of justifiable limitations to patient autonomy. Each scenario is examined in the light of different moral theories including deontology, utilitarianism, communitarianism and principlist ethical reasoning. Kantian ethical reasoning is found to be resilient in rejecting any limitation to the autonomy principle whereas each of the other theories allow greater scope for morally-justified curtailment of individual autonomy. The thesis concludes with reflection on post-modern society in which the radicalization of what began with the European Enlightenment sees the transformation of pre-modern society into a global community in which epistemological certainty is no longer available. In this environment, the emerging emphasis on global responsibility requires ethical accountability, not only when individuals secure transactions between one another but also between individuals and unknown communities of men and women of current and future generations. The thesis concludes that patient autonomy is justifiably limited in South African medical practice because of issues related to social justice but that the impact of the new genetic technologies and post-modernity itself may in future set new limits to individual patient autonomy.
OPSOMMING: Die Europese Verligting het die mensdom bevry van verstarde, dogmatiese denke. Wetenskaplike en tegnologiese ontwikkelinge het tydens the 18de Eeu die lewens van almal radikaal verander. Die mens se bemeestering en transformasie van sy omgewing het gepaard gegaan met revolusionêre politieke hervormings wat gelei het tot die ontbinding van tradisionele politieke ryke en die oordrag van mag aan die mens. Sosiale transformasie het veroorsaak dat die politieke ordeninge van voor-moderne mense deur ‘n globale gemeenskap vervang is wat ontstaan het as gevolg van onder meer die ontkoppeling van tyd en plek (Giddens), en wat deur nuwe tegnologiese ontwikkelings en die ontstaan van simboliese vorms moontlik gemaak is. Hierdie uitgebreide ontwikkelinge het die idee laat ontstaan dat niks vir die 18de Eeuse mens onmoontlik is nie. Die mens het geglo dat hy ‘n reg het op self-bestuur en outonome besluite. Kant het die morele outonomie van die mens beskou as sy vryheid om verantwoordlikheid te neem vir sy eie rasioneel-begronde handelinge en verder het hy ‘n besondere waardigheid in die mens geïdentifiseer vanweë sy morele outonomie. Omdat ‘n mens hierdie eienskap besit, beskik hy oor ‘n hoër waardigheid as alle alle ander lewensvorme. Persoonlike outonomie is die uitoefenimg van die vrye wil van die individu en word om geregverdigde redes beperk deur die regte van ander mense. Die beginsel van outonomie met verwysing na mediese etiek het nie voor die begin van die 20ste eeu prominent geword nie. Voor hierdie tyd het mediese etiek staatgemaak op die goeie voorneme van die praktisyn. Die grense van individuele outonomie word nou bepaal deur die noodsaak van sosiale geregtigheid. Al is dit die geval, bly die beginsel van outonomie die belangrikste beginsel in die etiese debat en word meestal gesien as ‘n deel van die proses van ingeligte toestemming. Hierdie tesis verskaf ‘n omvattende ontleding van outonomie met betrekking tot ingeligte toestemming. Daarna word verskillende kliniese gevalle beskryf en ontleed, en verskeie etiese teorieë gebruik om die wyse waarop pasiënt outonomie reverdigbaar ingekort behoort te word, te bespreek. Die teorie van Kant is in staat om enige inkorting van outonomie in alle gevalle the weerstaan. Elkeen van die ander teorieë verskaf redes waarom die outonomie van individuele pasiënte legitiem ingekort mag word. Hierdie werk sluit af met besinning oor die post-moderne gemeenskap wat ‘n globale samelewing moet aanvaar sowel as die ontoereikenheid van enige kenteoretiese sekerheid. Die ontwikkelende verantwoordelikheid vir die totale mensdom in hierdie wêreld veroorsaak dat individue nie meer slegs moet besluit oor die morele verhouding met sy medemens nie, maar ook oor sy verhouding met mense van gemeenskappe wat geskei is in tyd en ruimte, insluitend sy verhouding met die mense van toekomstige generasies. Hierdie werk sluit af met die gevolgtrekking dat pasiënt outonomie regverdigbaar beperk word in die Suid Afrikaanse mediese praktyk deur die noodsaaklikheid van sosiale geregtigheid. Die verwagte impak van nuwe genetiese tegnologieë en die ontwikkeling van ‘n post-moderne gemeenskap mag nuwe beperkings bring vir pasiënt outonomie.
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Lasseter, Gemma Michelle. "Consent study : assessing the public's willingness to provide informed consent for their identifiable general practice medical records to be accessed for different research purposes." Thesis, University of Bristol, 2016. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.702735.
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Objectives: Patient involvement in primary care research is often hindered by confidentiality concerns regarding the use of their identifiable medical records. Consequently there is no universal 'pre-consent' process in England, whereby patients provide prior informed consent for their identifiable data to be accessed for different research purposes. This mixed-methods two-phase study investigated patients' opinions about this proposed 'pre-consent' process and the effectiveness of different invitation methods. Methods: Phase 1 used cognitive and semi-structured interview methods to optimise recruitment documents for, and ascertain participants' attitudes towards, providing an informed consent decision for the 'pre-consent' process. Phase 2 tested the feasibility of different recruitment documents ('standard' and 'modified') and invitation methods (postal, consultation and new) to determine the most effective in terms of allowing patients the opportunity to provide an informed consent decision. Results: Phase 1: Readability of the 'standard' recruitment documents impacted on participants' abilities to provide consent decisions, consequently a 'modified' version was created using participant feedback. Opinions about the 'pre-consent' process were chiefly affected by an individual's personal attitudes; key findings were 'data security' concerns and 'public benefit' motives. Phase 2: Recruitment documents affected response rates, with patients that received 'standard' documents 43% less likely to re~pond than those receiving the 'modified' documents. Postal, consultation and new invitation methods biased the types of patients invited, the number and types of patients responding, and the consent levels provided. Of the 2550 patients invited to participate in the 'pre-consent' process, only 30% (n=767/2550) responded, undermining the feasibility of this process. Discussion: The 'pre-consent' process seems currently unfeasible. However, engaging with the public to identify the most effective recruitment documents, invitation methods and consent options could streamline research in primary care. These approaches, employed on a study-by-study basis, would ensure primary care research remains cost-effective and representative of the general population.
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Kerner, David Neal. "Impact of a decision aid videotape on young women's attitudes and knowledge about hormone replacement therapy /." Diss., Connect to a 24 p. preview or request complete full text in PDF format. Access restricted to UC campuses, 1998. http://wwwlib.umi.com/cr/ucsd/fullcit?p9901432.
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Cai, Yinghong, and 蔡映紅. "The legal rights in informed consent form for treatment in China." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2007. http://hub.hku.hk/bib/B39724347.
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Torres, Roberto. "Communicating informed consent with LEP participants during clinical trials| A case study." Thesis, University of Phoenix, 2015. http://pqdtopen.proquest.com/#viewpdf?dispub=3691421.
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Healthcare systems are under pressure to eliminate disparities of care. Communication methods used with Limited English Proficiency (LEP) patients was presented in the literature as an essential component to deliver quality and equal care. Several strategies have been implemented to assess and target the communication methods between patients and health care teams. The challenge for health systems workers is to address communication barriers to eliminate disparities of care and medical errors. The purpose of the present qualitative case study was to explore if communication barriers affect the understanding of LEP research participants while participating in the informed consent process during clinical trials. Communication barriers during the informed consent process may affect clinical trial outcomes. In the study, the use of a triangulation data gathering method was associated with a qualitative case study. Data regarding barriers of communication during the informed consent process were gathered by performing semistructured interviews. The study population included six principal investigators, five interpreters, and nine LEP research participants. Data analysis involved reviewing the emerging themes from participants’ responses. Results indicated four major themes supporting communication challenges. The themes included authority figure, cultural sensitivity, communication barriers, and education. The study suggested the need for further research regarding communication barriers during the clinical trials process.
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Kious, Brent Michael. "The evidentiary account of consent's moral significance." Diss., Restricted to subscribing institutions, 2009. http://proquest.umi.com/pqdweb?did=1930280011&sid=1&Fmt=2&clientId=1564&RQT=309&VName=PQD.
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Flanagan, Ellen Cecelia. "AN URBAN BIOETHICS APPROACH TO PARENTAL INFORMED CONSENT FOR PEDIATRIC CLINICAL RESEARCH." Master's thesis, Temple University Libraries, 2018. http://cdm16002.contentdm.oclc.org/cdm/ref/collection/p245801coll10/id/537038.
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Urban BioethicsM.A.
In the current healthcare landscape, parents generally make decisions regarding whether or not their children are allowed to take part in clinical research, with the general assumption being that parents know what is best for children. Investigations have been conducted regarding what is likely to lead parents to consent or not consent to their child’s participation in a trial, but research plans seldom incorporate the consideration that not all parents come into the consent process with equal social, academic, and economic footing. Since the burden of the ultimate decision lies primarily on the parents, it is supremely important that they are capable of making a well-informed and thoughtful choice. Bioethical understanding of the influence of parental decisions in clinical research must consider demographic variables and how they may affect parents’ decisions to allow or disallow their child to participate in a clinical trial. Those differences could affect the consent process and have ramifications for the research findings, as research results are affected in numerous ways by which children do, and do not, participate in studies. This paper looks specifically at parents in the process of informed consent for pediatric research, taking into account several social determinants of health and how they affect who participates in research and how that affects research as a whole.
Temple University--Theses
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Pease-Carter, Cheyenne. "Preferences among student counselors regarding informed consent practices within counselor education." Thesis, University of North Texas, 2008. https://digital.library.unt.edu/ark:/67531/metadc6066/.
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The purpose of this study was to investigate student preferences for content, timing, and method of informed consent within counselor education programs. Participants included 115 students enrolled in counseling internship courses at six counseling programs accredited by the Council for Accreditation of Counseling and Related Educational Programs (CACREP). Participants completed the Informed Consent Preferences Questionnaire (ICPQ), an instrument designed specifically for this study through systematic instrumentation development. Descriptive statistics highlighted participants' moderate to high ratings of perceived importance for an array of suggested content pieces for student informed consent. Participants varied among themselves and between items in relation to preferred timing of informed consent, and they consistently reported a desire for student informed consent to be facilitated through a combination of both oral and written methods. Results of exploratory factor analysis revealed a simple eight-factor structure within the ICPQ and suggested strong internal reliability. Correlations for participant scale scores for the eight factors revealed a variety of small to medium correlations. Results from t-test and one-way analysis of variances (ANOVA) indicated that participant preferences did not vary according to demographic variables. Finally, participants' qualitative responses revealed high levels of support for student informed consent. Findings of this study may aid counselor educators in evaluating current program informed consent practices. As a result of evaluation, counselor educators can affirm existing, and/or design new informed consent practices that accurately reflect the needs and desires of counseling students. Future researchers may also utilize the results to guide additional studies related to the practice of student informed consent.
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Tomita, Kiyomi. "Informed consent and the right to refuse medical treatment : a comparative study of common-law Canada and Japan." Thesis, McGill University, 1992. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=61156.
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Common law in Canada recognizes the rights to self-determination and autonomy and the right of competent persons to decide for themselves on medical treatment which includes the right to refuse all treatment. The legal profession has caused Japanese law to begin to recognize these basic rights, however professional and societal factors combine to accord the Japanese physician a wide discretion to determine what information to disclose, especially in the case of cancer. This thesis examines the similarities and differences existing between Canada and Japan in the controversial area of informed consent and the patient's right to refuse treatment and as well as the current attitudes within the legal and medical professions in Japan toward recognition and enforcement of these rights.
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Tamin, Jacques. "The doctor-patient relationship, confidentiality and consent in occupational medicine : ethics and ethical guidance." Thesis, University of Manchester, 2016. https://www.research.manchester.ac.uk/portal/en/theses/the-doctorpatient-relationship-confidentiality-and-consent-in-occupational-medicine-ethics-and-ethical-guidance(586107a4-ffe5-40be-ad19-acb9d329d732).html.
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This thesis seeks to examine the ethical basis for occupational medicine, as it is practised in the United Kingdom (UK). There is empirical evidence of occupational physicians being confused with regard to confidentiality and consent, and variations in their practice. It is argued that the ethical guidance from the General Medical Council and the Faculty of Occupational Medicine on these matters, contributes significantly to such confusion. The doctor-patient relationship, consent for disclosure of a medical report, and medical confidentiality, all in the context of occupational medicine practice, are explored. These issues are addressed in the core part of this thesis in the form of the three published papers. In the first paper, the doctor-patient relationship in occupational medical practice is reviewed, and it becomes apparent that in the UK, the occupational physician carries out different roles and functions, ranging from duties that mirror those of a therapeutic encounter, to those that require the occupational physician to be completely independent for the purposes of a particular type of assessment (for ill-health retirement). The former is compatible with the assumption of a fiduciary relationship between doctor and patient, whereas in the latter situation, it would be incongruous to expect the doctor to be independent and owe the patient a “duty of undivided loyalty” simultaneously. In the second paper, consent for disclosure of information, in particular a medical report, is distinguished from the “informed consent” for treatment or interventional research, and the phrase “permission to disclose” is proposed for the disclosure situations. Although this distinction may not have much significance in therapeutic practice, the output of virtually all occupational physician activities results in the writing of a report, so this difference between the two “consents” has greater relevance. The third paper reviews the ethical, and in particular, legal basis for medical confidentiality with reference to an independently commissioned report. In such a situation, UK courts have been consistent in stating that disclosure of such a report to the commissioning party does not breach confidentiality, and no further consent for such disclosure is required. This conflicts with ethical guidance to occupational physicians on this matter. Such conflict between the law and ethical guidance are a further, and important, source of ethical confusion for occupational physicians. Indeed, a common theme through the three papers is that ethical guidance to occupational physicians is in parts either incongruent, incoherent, or conceptually flawed. This may not be surprising, as current ethical guidance is predicated on a doctor-patient relationship that exists in the usual setting for most doctor-patient encounters, that is, the therapeutic setting. It seems unreasonable to expect that simply transposing such an ethical paradigm into a different setting, with dissimilar roles and obligations, could work in a seamless manner. The occupational physicians’ ethical confusion thus reflects the confusion in their ethical guidance.
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Wik, Michaela. "Children´s consent to medical treatment : with emphasis on essential treatments and the procedural protection of children´s rights." Thesis, Stockholms universitet, Juridiska institutionen, 2014. http://urn.kb.se/resolve?urn=urn:nbn:se:su:diva-109664.
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Fulkerson, Dikuua Kelly Jo. "[Un]informed Consent: Eugenics, Forced Sterilization and Medical Violence in the Jim Crow United States and Apartheid Southern Africa." The Ohio State University, 2019. http://rave.ohiolink.edu/etdc/view?acc_num=osu1560981650973904.
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Jowett, Stephanie. "Legal barriers to consent for medical treatment of trans and gender diverse youth: A comparative and medico-legal analysis." Thesis, Queensland University of Technology, 2020. https://eprints.qut.edu.au/203611/1/Stephanie_Jowett_Thesis.pdf.
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Legal and clinical complexities continue to develop surrounding medical treatment for trans and gender diverse youth in Australia. This thesis employed a comparative and medico-legal lens to evaluate the law in Australia against medical knowledge regarding consent to treatment of trans and gender diverse youth. These analyses determined whether Australian law is congruent with medical science, and whether law reform is needed. The law in England and Wales was also analysed to determine whether any differences may inform Australian law reform. The thesis drew conclusions for law reform and optimal clinical practice for trans and gender diverse youth.
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Kettle, Nancy M. "Informed consent: its origins, purpose, problems, and limits [electronic resource] / by Nancy M. Kettle." University of South Florida, 2002. http://purl.fcla.edu/fcla/etd/SFE0000041.
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Title from PDF of title page.Document formatted into pages; contains 165 pages.
Thesis (M.A.)--University of South Florida, 2002.
Includes bibliographical references.
Text (Electronic thesis) in PDF format.
ABSTRACT: The doctrine of informed consent, defined as respect for autonomy, is the tool used to govern the relationship between physicians and patients. Its framework relies on rights and duties that mark these relationships. The main purpose of informed consent is to promote human rights and dignity. Some researchers claim that informed consent has successfully replaced patients&softsign; historical predispositions to accept physicians' advice without much explicit resistance.
Although the doctrine of informed consent promotes ideals worth pursuing, a successful implementation of these ideals in practice has yet to occur. What has happened in practice is that attorneys, physicians, and hospital administrators often use consent forms mainly to protect physicians and medical facilities from liability. Consequently, ethicists, legal theorists, and physicians need to do much more to explain how human rights and human dignity relate to the practice of medicine and how the professionals can promote them in practice.
This is especially important because patients' vulnerability has increased just as the complexity and power of medical science and technology have increased. Certain health care practices can shed light on the difficulties of implementing the doctrine of informed consent and explain why it is insufficient to protect patients' rights and dignity. Defining a normal biological event as a disease, and routinely prescribing hormone drug therapy to menopausal women for all health conditions related to menopause, does not meet the standards of free informed consent.
Clinicians provide insufficient disclosure about risks related to long-term use of hormone therapies and about the absence of solid evidence to support their bias toward hormone therapies as a treatment of choice for menopause related health conditions. The contributing problem is women's failure to act as autonomous agents because they either choose not to take an active part in their own therapy or because they fear to question physicians' medical authority. To insure that patients' autonomy and free choice are a part of every physician-patient interaction, physicians and patients need actively to promote them as values that are absolutely indispensable in physicians' offices, clinics, and hospitals.
System requirements: World Wide Web browser and PDF reader.
Mode of access: World Wide Web.
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Rossouw, Theresa Marie. "Identity, personhood and power : a critical analysis of the principle of respect for autonomy and the idea of informed consent, and their implementation in an androgynous and multicultural society." Thesis, Stellenbosch : Stellenbosch University, 2012. http://hdl.handle.net/10019.1/19906.
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Thesis (PhD)--Stellenbosch University, 2012.ENGLISH ABSTRACT: Autonomy and informed consent are two interrelated concepts given much prominence in contemporary biomedical discourse. The word autonomy, from the Greek autos (self) and nomos (rule), originally referred to the self-governance of independent Hellenic states, but was extended to individuals during the time of the Enlightenment, most notably through the work of Immanuel Kant and John Stuart Mill. In healthcare, the autonomy model is grounded in the idea of the dignity of persons and the claim people have on each other to privacy, self-direction, the establishment of their own values and life plans based on information and reasoning, and the freedom to act on the results of their contemplation. Autonomy thus finds expression in the ethical and legal requirement of informed consent. Feminists and multiculturalists have however argued that since autonomy rests on the Enlightenment ideals of rationality, objectivity and independence, unconstrained by emotional and spiritual qualities, it serves to isolate the individual and thus fails to rectify the dehumanisation and depersonalisation of modern scientific medical practice. It only serves to exacerbate the problematic power-differential between doctor and patient. Medicine is a unique profession since it operates in a space where religion, morality, metaphysics, science and culture come together. It is a privileged space because health care providers assume responsibility for the care of their patients outside the usual moral space defined by equality and autonomy. Patients necessarily relinquish some of their autonomy and power to experts and autonomy thus cannot account for the moral calling that epitomizes and defines medicine. Recognition of the dependence of patients need not be viewed negatively as a lack of autonomy or incompetence, but could rather reinforce the understanding of our shared human vulnerability and that we are all ultimately patients. There is however no need to abandon the concept of autonomy altogether. A world without autonomy is unconceivable. When we recognise how the concept functions in the modern world as a social construct, we can harness its positive properties to create a new form of identity. We can utilise the possibility of self-stylization embedded in autonomy to fashion ourselves into responsible moral agents that are responsive not only to ourselves, but also to others, whether in our own species or in that of another. Responsible agency depends on mature deliberators that are mindful of the necessary diversity of the moral life and the complex nature of the moral subject. I thus argue that the development of modern individualism should not be rejected altogether, since we cannot return to some pre-modern sense of community, or transcend it altogether in some postmodern deconstruction of the self. We also do not need to search for a different word to supplant the concept of autonomy in moral life. What we rather need is a different attitude of being in the world; an attitude that strives for holism, not only of the self, but also of the moral community. We can only be whole if we acknowledge and embrace our interdependence as social and moral beings, as Homo moralis.
AFRIKAANSE OPSOMMING: Outonomie en ingeligte toestemming is twee nou verwante konsepte wat beide prominensie in moderne bioetiese diskoers verwerf het. Die woord outonomie, van die Grieks autos (self) en nomos (reël), het oorspronklik verwys na die selfbestuur van onafhanklike Griekse state, maar is in die tyd van die Verligting uitgebrei om ook na individue te verwys, grotendeels deur die werk van Immanuel Kant en John Stuart Mill. In medisyne is die outonomie model gegrond op die idee van die waardigheid van die persoon en die beroep wat mense op mekaar het tot privaatheid, selfbepaling, die daarstelling van hulle eie waardesisteem en lewensplan, gebasseer op inligting en redenasie, en die vryheid om op die uitkoms van sulke redenasie te reageer. Outonomie word dus vergestalt in die etiese en wetlike bepaling van ingeligte toestemming. Feministe en multikulturele denkers beweer egter dat, siende outonomie gebasseer is op die Verligting ideale van rasionaliteit, objektiwiteit en onafhanklikheid, sonder die nodige begrensing deur emosionele en spirituele kwaliteite, dit die individu noodsaaklik isoleer en dus nie die dehumanisering en depersonalisering van moderne wetenskaplike mediese praktyk teenwerk nie. As sulks, vererger dit dus die problematiese magsverskil tussen die dokter en pasiënt. Die beroep van medisyne is ‘n unieke professie aangesien dit werksaam is in die sfeer waar geloof, moraliteit, metafisika, wetenskap en kultuur bymekaar kom. Dit is ‘n bevoorregde spasie aangesien gesondheidswerkers verantwoordelikheid vir die sorg van hulle pasiënte aanvaar buite die gewone morele spasie wat deur gelykheid en outonomie gedefinieer word. Pasiënte moet noodgedwonge van hulle outonomie en mag aan deskundiges afstaan en outonomie kan dus nie genoegsaam die morele roeping wat medisyne saamvat en definieer, vasvang nie. Bewustheid van die afhanklikheid van pasiënte hoef egter nie in ‘n negatiewe lig, as gebrek aan outonomie of onbevoegtheid, beskou te word nie, maar moet eerder die begrip van ons gedeelde menslike kwesbaarheid en die wete dat ons almal uiteindelik pasiënte is, versterk. Dit is verder nie nodig om die konsep van outonomie heeltemal te verwerp nie. ‘n Wêreld sonder outonomie is ondenkbaar. Wanneer ons bewus word van hoe die konsep in die moderne wêreld as ‘n sosiale konstruk funksioneer, kan ons die positiewe aspekte daarvan inspan om ‘n nuwe identiteit te bewerkstellig. Ons kan die moontlikheid van self-stilering, ingesluit in outonomie, gebruik om onsself in verantwoordelike morele agente te omskep sodat ons nie slegs teenoor onsself verantwoordelik is nie, maar ook teenoor ander, hetsy in ons eie spesie of in ‘n ander. Verantwoordelike agentskap is afhanklik van volwasse denkers wat gedagtig is aan die noodsaaklike diversiteit van die morele lewe en die komplekse aard van die morele subjek. Ek voer dus aan dat die ontwikkeling van moderne individualisme nie volstrek verwerp moet word nie, siende dat ons nie na ‘n tipe premoderne vorm van gemeenskap kan terugkeer, of dit oortref deur ‘n postmoderne dekonstruksie van die self nie. Ons het verder ook nie ‘n nuwe woord nodig om die konsep van outonomie in die morele lewe mee te vervang nie. Ons het eerder ‘n ander instelling van ons menswees in die wêreld nodig; ‘n instelling wat streef na volkomendheid, nie net van onsself nie, maar ook van die morele gemeenskap. Ons kan slegs volkome wees wanneer ons ons interafhanklikheid as sosiale en morele entiteite, as Homo moralis, erken en aangryp.
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King, Hillary S. "An Ethically Informed Consideration of the Use of a Waiver of Informed Consent in Emergency Medicine Research." Ohio University / OhioLINK, 2013. http://rave.ohiolink.edu/etdc/view?acc_num=ohiou1366042483.
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Hicks, Michelle B. "Informed Consent in Obstetric Anesthesia: The Effect of the Amount, Timing and Modality of Information on Patient Satisfaction." Thesis, University of North Texas, 2008. https://digital.library.unt.edu/ark:/67531/metadc9771/.
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Using mainly quantitative methods of evaluation, as well as patient comment assessment, this study evaluated whether changing the current informed consent process for labor epidural analgesia to a longer, more informational process resulted in a more satisfied patient. Satisfaction with the labor epidural informed consent process was evaluated using a questionnaire that was mailed and also available online. Half of the patient population was given a written labor epidural risk/benefit document at their 36-week obstetric check up. All patients received the standard informed consent. Survey responses were evaluated based on three independent variables dealing with the modality, timing, amount of informed consent information and one dependent variable, whether the patient's expectations of the epidural were met, which is equated with satisfaction. Patients in this study clearly indicated that they want detailed risk/benefit information on epidural analgesia earlier in their pregnancy. A meaningfully larger percentage of patients who received the written risk/benefit document were satisfied with the epidural process as compared to those who did not receive the document.
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Houghton, Lindsey C. "Dementia and End-of-Life Decision Making: A Case-Based Approach to the Clinical Application of Bioethical Principles." Master's thesis, Temple University Libraries, 2019. http://cdm16002.contentdm.oclc.org/cdm/ref/collection/p245801coll10/id/549725.
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Urban BioethicsM.A.
People with dementia account for a growing number of patients requiring end-of-life medical care each year in the United States. The clinical application of bioethical principles is rarely more important than in the context of end-of-life decision making, and determining the appropriate clinical treatment plan can be difficult and complex for clinicians, patients, and medical proxies. While the current bioethical literature offers a wealth of information on the principles underlying ethical medical practice, real-world clinical scenarios are often fraught with confusion, complexity, and conflicting understandings of best practices. There is a need for clinical decision-making tools that are both comprehensive yet simple, and broadly-applicable enough to be clinically useful. This thesis explores the cultural factors that necessitate further discussion and understanding of the issues surrounding end-of-life care for people with dementia, uses a clinical case to demonstrate a real-world approach to the ethical complexities surrounding such care, and proposes a basic ethical decision-making algorithm with the potential for broad application by students and clinicians encountering complex ethical scenarios.
Temple University--Theses
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Hicks, Michelle B. Wheeler Maurice B. "Informed consent in obstetric anesthesia the effect of the amount, timing and modality of information on patient satisfaction /." [Denton, Tex.] : University of North Texas, 2008. http://digital.library.unt.edu/permalink/meta-dc-9771.
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Rees, Gethin. "Corroboration, consent and community : a 'meaning finitist' account of the forensic medical examination of rape and penetrative sexual assault complainers in Scotland." Thesis, University of Edinburgh, 2009. http://hdl.handle.net/1842/3428.
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This thesis examines the construction of forensic medical evidence in penetrative sexual assault cases and the procedures that Forensic Medical Examiners (FMEs) employ in order to ensure the authority of that evidence. Drawing upon interviews and on the texts and artefacts that FMEs use in their work, the thesis employs the concept of “meaning finitism” to analyse how FMEs perform forensic examinations for evidential purposes. The thesis starts with an exploration of how medical practitioners are taught to identify and classify injuries of medico-legal significance, culminating in their being judged “safe” to provide expert testimony by other members of the clinical forensic medical community. The thesis next addresses the construction of what I call the “morphological account”: a set of judgements about the nature of a case based upon a combination of the observed injuries, the FME’s training and their previous experience of cases. While there is considerable agreement amongst practitioners about how to interpret injuries (a result of their training), because the morphological account involves personal judgement, there is also scope for differences of opinion. The thesis therefore explores the methods that FMEs employ to limit the risk of being seen to disagree with one another during trials. The thesis also examines the role that guidelines play in the forensic medical examination. The thesis argues that standardised medical kits and associated guidance documents were originally introduced in the early 1980s in response to sustained criticism of FMEs’ practices, and further developed in the late 1990s and early 2000s with the rise of Evidence-Based Medicine. Kits and guidance documents provide a means for FMEs to legitimate and explain their work to others, particularly during trials: they codify collective practice and provide FMEs with an aide memoire of the requisite procedures, without overly determining or constraining practice. Finally, I will argue that FMEs’ concern to ensure the authority of their evidence may sometimes limit the value of that evidence. Caution over drawing inferences that might be challenged in court, and a concern not to be seen as “prosecution-minded”, commonly leads FME to compose so-called “Neutral Reports” which neither confirm nor deny the complainer’s allegations. As Scottish Procedural Law makes provision for non-contentious evidence to be removed from trial, such neutral reports are likely to be dismissed from consideration.
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Carmack, Heather J. "How to Say I'm Sorry: A Study of the Veterans Administration Hospital Association's Apology and Disclosure Program." Ohio : Ohio University, 2008. http://www.ohiolink.edu/etd/view.cgi?ohiou1209039528.
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Medina, Eva. "Le principe d’autonomie de la volonté de la patiente enceinte avant l'accouchement: modèle de communication hospitalière." Doctoral thesis, Universidad de Alicante, 2021. http://hdl.handle.net/10045/115363.
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La thèse présentée est intitulée « Le principe d’autonomie de la volonté de la patiente enceinte avant l’accouchement: Modèle de communication hospitalière ». Le travail de recherche est essentiellement méthodologique. Il comporte également une partie d’étude empirique, des enquêtes sous forme de témoignages auprès de plus de 500 patientes ayant subi une IVG en Europe. Il contribue à un thème de recherche important, la mise en place des mécanismes juridiques nécessaires à l’évolution des stratégies de santé publique du droit à l’IVG. La thèse est structurée en deux grandes parties : I. La consécration de l’autonomie de la femme lors d’une grossesse indésirée II. Les atteintes à l’autonomie de la femme lors d’une grossesse indésirée (modèle de communication) Ce découpage met en évidence le développement juridique autour de la remise en cause de la procédure d’accès à l’IVG par un éclairage de l’autonomie de la patiente. La première partie est divisée en deux titres qui présentent le respect de l’autonomie et le recueil du consentement. Le travail de recherche se construit par une analyse des données nécessaires pour évaluer les impacts du consentement perverti par le profane et le milieu médical dans lequel il s’inscrit. La deuxième partie propose deux titres qui présentent la responsabilité médicale et l’effet relatif des responsabilités quant à l’autonomie de la femme enceinte, permettant d’analyser les limites à la détermination de la patiente, le préjudice subi de la perte d’autonomie et les inégalités qui découlent des traitements différents selon les législations en vigueur. Malgré l’impossibilité de conclure à priori sur l’autonomie du processus de décision médicale, des solutions juridiques sont néanmoins proposées dans le dernier chapitre : il s’agit d’une étude de cas pour le renforcement juridique du consentement de la patiente (2019) menée aux Hôpitaux de Genève (HUG) en Suisse permettant, notamment, une déconstruction du principe de « libre-choix » de la patiente. Loin d’entrer dans une logique critique et antinomique pro-IVG, la thèse propose d’analyser les failles procédurales (le paradoxe de la responsabilité médicale) dans une étude nourrie de réflexions juridiques sur la notion d’autonomie et le statut de la femme lors de la décision IVG.The thesis presented is entitled "The principle of autonomy of will of the pregnant patient before giving birth : a hospital communication model. The research work is essentially methodological. It also includes a part of empirical study, surveys in the form of testimonies with more than 500 patients having undergone a VTP care, in the 3 European countries determined in the study, in France, Poland and Switzerland. It contributes to an important research theme, the establishment of the legal mechanisms necessary for the evolution of public health strategies of the VTP right. The thesis is structured in two main parts : I. The recognition of women's autonomy when deciding on the use of the VTP care. II. Violations of women's autonomy when deciding on the use of the VTP care (hospital communication model). This division highlights the legal development around the questioning of the procedure of access to the VTP care by a lighting of the autonomy of the patient. The first part is divided into two titles that show respect for autonomy and the collection of consent. The research work is constructed by an analysis of the data needed to evaluate the impact of perverted consent by the lay person and the medical community in which he is enrolled. The second part proposes two titles that present the special medical responsibility and the relative effect of responsibilities on the autonomy of the pregnant woman, allowing to analyze the limits to the determination of the patient, the harm suffered from the loss of autonomy and the inequalities that result from different treatments according to the legislation in force. Despite the impossibility of concluding a priori on the autonomy of the medical decision-making process, legal solutions are nevertheless proposed in the last chapter : it is a case study for the legal strengthening of the patient's consent (2018) conducted at the Geneva Hospitals (HUG) in Switzerland allowing, in particular, a deconstruction of the principle of "free choice" of the patient. Far from entering a critical and antinomic pro-VTP logic, the thesis proposes to analyze the procedural flaws (the paradox of medical responsibility) in a study nourished by legal reflections on the notion of autonomy and the status of women during the decision IVG.
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Lhermite, Astrid. "Éthique des soins aux personnes âgées : la capacité à consentir et traitement involontaire." Thesis, Toulouse 2, 2014. http://www.theses.fr/2014TOU20012/document.
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Notre recherche concerne l’éthique des soins prodigués aux personnes âgées institutionnalisées, spécialement les questions de la capacité à consentir et du traitement involontaire. Notre travail est basé sur la Théorie Fonctionnelle de l'Intégration de l'information de N.H. Anderson (1981). En ce qui concerne l'étude portant sur la capacité à consentir : 98 Hommes de la rue, 21 psychologues, 37 infirmières et 14 médecins ont jugé de la capacité de la personne âgée à faire des choix dans chacun des 50 scénarios proposés, résultants de la combinaison de trois facteurs: "type de Décision", "type de Trouble", et "Soutien social". Pour l'étude portant sur le traitement involontaire : 101 personnes du grand public, 20 psychologues, 20 infirmières et 10 médecins ont jugé de l'acceptabilité du traitement involontaire des 48 scénarios proposés, combinaison de quatre facteurs: "type de Trouble", "Décision du médecin", "Explications données au résident ", "état Cognitif". Les résultats montrent que pour les deux études, le grand public et les professionnels de santé ont intégré les facteurs de la même manière. Pour la première étude, le facteur « type de Trouble » a le plus de poids, suivi par le facteur « Soutien social ». Quatre groupes de répondants se distinguent par les poids qu'ils donnent aux différents facteurs. Concernant l'étude portant sur le traitement involontaire, le facteur le plus influent est « Explications», suivi par « Décision du médecin ». Trois groupes de répondants se distinguent en fonction des patterns de réponse. Les variables individuelles telles que l’âge, le sexe, le niveau d’éducation et l’expérience n’ont pas d’effet. L'évaluation de la capacité à consentir et l’acceptabilité du traitement involontaire sont influencées par les facteurs proposés et il apparaît qu’il existe des positions différentes face à ces questions éthiquesOur research deals with ethical questions in gerontology, especially the capacity to consent and involuntary treatment. Our research is based on the Integration Information Theory of N.H. Anderson (1981). 98 lay people, 21 psychologists, 37 nurses and 14 physicians judged a nursing home resident’s capacity to consent on 50 scenarios combining 3 factors : “type of Decision”, “type of Problem”, “social Support”. 101 lay people, 20 psychologists, 20 nurses and 10 physicians judged the acceptability of involuntary treatment on 48 scenarios combining 4 factors : “type of Disease”, “physician’s Decision”, “Explanations”, and “Cognitive status”. Results don’t show differences between lay people and health professionals in the way they integrate the factors presented. In the first study, the factor “type of Problem” is the most significant, followed by “social Support”. 4 groups of participants distinguish themselves by the way the weigh the factors. In the second study, the factor “Explanations” is the most significant, followed by “physician’s Decision”. 3 groups of participants distinguish themselves. Individual variables like age, gender, educational level or experience have no effect. Assessment of the capacity to consent and acceptability of involuntary are influenced by the factors presented and it appears that there are different positions among the participants
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Fausset, Cara Bailey. "Comprehension of health risk probabilities: the roles of age, numeracy, format, and mental representation." Diss., Georgia Institute of Technology, 2012. http://hdl.handle.net/1853/44832.
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Probabilities, an essential dimension of risk communication, can be presented in various formats including frequencies (e.g., 1 in 10), percentages (e.g., 10%), or verbal phrases (e.g., unlikely); the literature is mixed concerning which format best supports comprehension. Additionally, it is not well understood how people who vary in their level of numeracy understand those probabilities. The goal of the present three-phase within-participant study was to understand how the factors of format and numeracy influence comprehension and mental representations of probabilities for younger and older adults. Overall, the results of this research clearly indicated that comprehension and mental representation of health risk probabilities are influenced by format, age, and numeracy. To best support comprehension and comparison of health risk probabilities for younger adults and healthy older adults with varying numeracy, percent format should be used.
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Kennedy, Judith Ronelle Graduate Program in Professional Ethics School of Philosophy UNSW. "The treatment engagement model as a tool for identifying problematic doctor behaviour. Three case studies." Awarded by:University of New South Wales. Graduate Program in Professional Ethics, School of Philosophy, 2006. http://handle.unsw.edu.au/1959.4/28220.
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This thesis is an exploration of professional behaviour in health care settings, using a Model of Treatment Engagement that is developed as a tool for ethics critique. The Model is tested and refined using data on: a psychiatric ???treatment??? carried out on over 1,127 occasions in a 15 - 40 bed non-acute hospital during the period 1961-1979; the problematic withdrawal of all life-support from a 37 year old man who had suffered acute brain trauma some five days previously, in a tertiary hospital in March 2000; and a clinical experiment recently proposed for the emergency setting and intended to encompass five hospitals and the NSW Ambulance Service. In each case, the Model proves useful in identifying the shift from the treatment paradigm and the ethical imperative of ensuring the patient (or his/her agent) appreciates the difference between what is proposed and what would normally be done. It reveals how doctors who dealt with the patient but did not decide on treatment contributed to ethically troublesome practice. It clarifies how having multiple doctor players in the treatment situation gave rise to the need to suppress dissenting views. Doctors who were close enough to the action to comprehend its nature, by not dissenting, reinforced the problematic choice for the actor and validated it in the eyes of observers. The lack of dissent at the level of doctors working under supervision, appeared to be a function of institutional arrangements. At the consultant level, there was evidence of pressure to concur from other consultants and indirect evidence of a fear of ostracism. The public responses in the two modern cases point to there being a strong idea in Sydney???s medical community that dissent should not be publicly displayed once a decision on how to treat has been made. I conclude there are two steps to reviewing ethically problematic treatment situations. The first consists of identifying the shift from the treatment paradigm. The second consists of establishing why the problematic choice is translated into action. The Treatment Engagement Model is put forward as a useful tool for both these analyses.
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JHU, YU-CHEN, and 朱育辰. "The Inapplicability of Informed Consent to Medical Criminal Law - The Position of Patients’ Consent in Medical Criminal Law." Thesis, 2018. http://ndltd.ncl.edu.tw/handle/azwej4.
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碩士國立臺北大學
法律學系一般生組
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The development of informed consent is to guarantee the right of patients’ self-determination. It is generally accepted by the general public that doctors should obtain patients’ consent by informing the medical treatment. And doctors’ explanation of medical behaviors to patients is also called doctors’ duty of disclosure. With the bad communication between doctors and patients is lead to the increasing of the medical lawsuits. Especially, doctors will be subject to criminal accusation by violating the doctrine of informed consent. However, whether doctors violate the right of patients’ self-determination or not, it doesn’t necessary to commit an intention or negligent crime. In order to establish a correct value, this thesis will based on related academic studies, and recent judgements by the Supreme Court. Furthermore, this thesis will in Chapter II & III to discuss the meaning of medical behaviors and informed consent. Second in Chapter IV & V, this thesis will analyze the position of patients’ consent in medical criminal law and explain the reasons about informed consent isn’t apply for medical criminal law. Last but not least, well doctor-patient relationship and communication is the best way to protect patients’ autonomy, rather than wants to put doctors to the jail.
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Wu, You-Lin, and 吳侑臨. "A study on the Medical Informed Consent." Thesis, 2019. http://ndltd.ncl.edu.tw/handle/vh42ru.
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碩士亞洲大學
財經法律學系
107
“Informed Consent”—doctor’s duty to inform—is the premise of the right of patient autonomy. Without emphasizing the importance of the duty, one cannot make a concrete discourse on the right. When the right has been the center of legal-medical discussion/debate for years, the duty has been transformed from a medical ethic issue into a legal obligation in Taiwan. Regardless of the aforementioned transformation, a thorough legal examination and discussion has not yet been made in Taiwan. This thesis intends to fill the research blank, and discuss the duty, starting from the duty’s basic concepts--human rights, human dignity, patient autonomy, and health care right, to its relevant civil, criminal, and procedural law issues. This thesis will also analyze Taiwanese court decisions to show how Taiwanese judiciary treats the informed consent issue. Lastly, this thesis will conclude with the need to introduce the idea of legal risk into the discourse of the duty in Taiwan. “An ounce of informed consent is worth a pound of malpractice defense,” as the old saying goes. This thesis argues that taking legal risk into consideration of constructing the concept of the duty can reduce unnecessary legal medical conflicts between doctors and patients.
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CHIEN, KUAN-YI, and 錢冠頤. "Re-examining 「Informed Consent」 in Medical Criminal Law." Thesis, 2017. http://ndltd.ncl.edu.tw/handle/2q94r4.
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碩士國立臺北大學
法律學系一般生組
105
To protect patients’ self-determination (autonomy), informed consent imposes a duty upon physicians to share information with their patients before getting consent. When a physician doesn’t obtain a patient’s consent or even goes against the patient’s medical will in violation of the doctrine of informed consent, the physician maybe will be subject to criminal accusation, and there is a huge gap between the legal and medical professions. First, this thesis discusses the meaning of medical behaviors, analyzes the position of medical behaviors in criminal law and the relation between medical behaviors and justification. Second, this thesis introduces the history of patients’ self-determination and has relations with informed consent. And then analyzing the physician’s obligation to explain and the patients’ consent. At last, some important judgments have indicated that the physicians who have not implement their duty to warn, before they start invasive medical treatments, will commit the criminal duty. But the violation of informed consent is still a controversial issue, so this thesis try to Re-examining the 「Informed Consent」 in Medical Criminal Law.
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Hung, Min-Yu, and 洪敏瑜. "The Legal Meaning of Informed Consent in Medical Research." Thesis, 2009. http://ndltd.ncl.edu.tw/handle/44670152154434486654.
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Lee, Yung-Lung, and 李永隆. "The Medical Informed Consent in Taiwan: Challenges and Solutions." Thesis, 2015. http://ndltd.ncl.edu.tw/handle/88677469447957182838.
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碩士逢甲大學
財經法律研究所
103
The doctrine of medical informed consent is a lofty ideal. After getting the sufficient medical information from the doctors, patients make decisions about the treatments of their disorders. The patients and doctors face and manage the disorders together and this doctor-patient communication process ensures the autonomy of the patients as well. However, the clinical practice of the communication is adverse to the doctors in Taiwan. Many patients file complaints against the doctors for failing to observe the formality and substance of informed consent. This thesis discusses the legal development and judicial decision of informed consent in the U.S. and Germany respectively. The author attempts to find a legal method to carry out the doctrine and discusses how to improve the clinical practice of informed consent in Taiwan. In the U.S., the theories of the extent of physician’s duty to disclose the risks of treatments are the “reasonable doctor standard” and the “reasonable patient standard”. The “reasonable doctor standard” is that the physician must disclose all risks that a reasonable doctor would disclose under the circumstances. The “reasonable patient standard” is that the physician should disclose the facts and risks that are likely to be relevant to the patient. The U.S. medical legal system emphasize on patients’ protection rather than doctors’ professional discretion. The doctors will lose the lawsuit if they do not disclose enough information to their patients even though the information may not be directly related to the outcome of the treatment. In Germany, on the other hand, the extent of physician’s duty is “reasonable patient standard”. Nevertheless, the settlements of medical disputes are based on the facts of the clinical situations and the medical judgments. The medical misfortunes will not attribute to doctors’ violation of informed consent. The conclusion of this thesis indicates the crucial issue of informed consent is the extent of the information disclosed by the doctors. The “reasonable doctor standard” and the “reasonable patient standard” couldn’t solve the medical disputes regarding informed consent in Taiwan. This thesis advocates establishing the “social informed standard”, the medical information offered to the patients edited by the medical professional societies and examined by the patient-interest protection groups. All patients under the same treatment shall be informed the standardized medical information which could be modified or improved by a feedback mechanism. Therefore, the patients could get the sufficient medical information and further make the appropriate decisions satisfying patient individual need. On account of the consistency of informed consent, the doctors could reduce or eliminate the medical litigations by disclosing the necessary information to their patients before performing the medical procedures.
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Formoso, José Vicente Feijó Queirós Rey Y. "Presumed Consent for Organ Donation." Dissertação, 2015. https://repositorio-aberto.up.pt/handle/10216/78933.
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