Variations on Consent.

Two articles in the March-April 2021 issue of the Hastings Center Report consider alterations to traditional informed consent. In "The Consent Continuum: A New Model of Consent, Assent, and Nondissent for Primary Care," Marc Tunzi and colleagues argue that, in primary care settings, patient consent should be understood as taking a range of forms depending on the procedure, the patient, and the patient-care context. Traditional informed consent is at the ceremonious end; for many things done in these settings, the authors assert, assent or even nondissent is fine. In the lead article, health policy scholars Stephanie Morain and Emily Largent consider another continuum for informed consent, this one occurring with pragmatic research, at the intersection of clinical care with research.

Kaebnick GE 《-》

The Consent Continuum: A New Model of Consent, Assent, and Nondissent for Primary Care.

The practice around informed consent in clinical medicine is both inconsistent and inadequate. Indeed, in busy, contemporary health care settings, getting informed consent looks little like the formal process developed over the past sixty years and presented in medical textbooks, journal articles, and academic lectures. In this article, members of the Society of Teachers of Family Medicine (STFM) Collaborative on Ethics and Humanities review the conventional process of informed consent and its limitations, explore complementary and alternative approaches to doctor-patient interactions, and propose a new model of consent that integrates these approaches with each other and with clinical practice. The model assigns medical interventions to a consent continuum defined by the discrete categories of traditional informed consent, assent, and nondissent. Narrative descriptions and clinical exemplars are offered for each category. The authors invite colleagues from other disciplines and from the academic ethics community to provide feedback and commentary.

Tunzi M ，Satin DJ ，Day PG 《-》

Learning Health Systems, Informed Consent, and Respect for Persons.

Several pieces in the Hastings Center Report's May-June 2022 issue concern research ethics issues that arise in learning health care systems. In the lead article, Stephanie Morain and colleagues propose a new ethical framework for pragmatic clinical trials (PCTs), which are trials embedded in clinical care. Their framework consists of eight dimensions of demonstrating respect for patients enrolled in PCTs. In the second article, Robert Steel argues that patients being treated in a learning health care system can be required to participate in a clinical trial even if the risk to them is more than minimal. If they wish to refuse, they must either forgo treatment in the system or seek it elsewhere. Three commentaries explore various dimensions of Steel's argument. A third article in the issue turns in a different direction, to assumptions in bioethics about the quality of lives lived with disability. The authors, Debjani Mukherjee, Preya Tarsney, and Kristi Kirschner, find much that needs to change and offer recommendations for improvements at multiple levels.

Kaebnick GE 《-》

Improving assent in health research: a rapid systematic review.

Soll D ，Guraiib MM ，Rollins NC ，Reis AA ... -  《BMC Medical Research Methodology》

Parental Perceptions About Informed Consent/Assent in Pediatric Research in Jordan.

Khabour OF ，Alomari MA ，Al-Sheyab NA 《-》