Money for research participation: does in jeopardize informed consent?

Some are concerned about the possibility that offering money for research participation can constitute coercion or undue influence capable of distorting the judgment of potential research subjects and compromising the voluntariness of their informed consent. The author recognizes that more often than not there are multiple influences leading to decisions, including decisions about research participation. The concept of undue influence is explored, as well as the question of whether or not there is something uniquely distorting about money as opposed to a chance for treatment or medical care. An amount of money that is not excessive and is calculated on the basis of time or contribution may, rather than constitute an undue inducement, be an indication of respect for the time and contribution that research subjects make.     

Is consent for research genuinely informed? Using decision aid tools to obtain informed consent in the global south

Gaining informed consent among marginalized groups that include decisionally incapacitated individuals and those outside of the researcher's own geo-social and ethnic background still challenges many researchers. We suggest that there is a need for consideration of a different approach to research ethics in international settings. Based on extensive field work in West Africa on medical knowledge transfers and patient–healer relationships, this paper will discuss the challenges posed in obtaining informed individual consent in international settings. It is argued that while being on the whole convincing, the top-down approach of the proposed solutions, which clearly dominates the participative approach, fails in building sustainable capacity, decision-making competency, and empowerment in the communities in which the research is conducted. Using appropriate decision aids can help resolve these issues.     

How informed is online informed consent?

We examined participants' reading and recall of informed consent documents presented via paper or computer. Within each presentation medium, we presented the document as a continuous or paginated document to simulate common computer and paper presentation formats. Participants took slightly longer to read paginated and computer informed consent documents and recalled slightly more information from the paginated documents. We concluded that obtaining informed consent online is not substantially different than obtaining it via paper presentation. We also provide suggestions for improving informed consent--in both face-to-face and online experiments.     

Anesthesiological ethics: can informed consent be implied?

Surgical ethics is a well-recognized field in clinical ethics, distinct from medical ethics. It includes at least a dozen important issues common to surgery that do not exist in internal medicine simply because of the differences in their practices. But until now there has been a tendency to include ethical issues of anesthesiology as a part of surgical ethics. This may mask the importance of ethical issues in anesthesiology, and even help perpetuate an unfortunate view that surgeons are "captain of the ship" in the operating theater (leaving anesthesiologists in a subservient role). We will have a better ethical understanding if we see surgery and anesthesia as two equal partners, ethically as well as in terms of patient care. Informed consent is one such issue, but it is not limited to that. Even on the topic of what type of anesthesia to use, anesthesiologists have often felt subsumed to the surgeon's preferences. This commentary takes the case study and uses it as a exemplar for this very claim: it is time to give due recognition for a new field in clinical ethics, ethics in anesthesia.     

Hide-and-seek or show-and-tell? Emerging issues of informed consent

This article reviews key philosophical and legal underpinnings of mental health professionals' obligation to obtain informed consent from consumers of their services. The basic components of informed consent are described, and strategies for clinically and ethically appropriate methods of obtaining informed consent are discussed. Emerging issues in informed consent involving duty to assess and protect against client dangerousness, obligations to third parties, and issues of deception are considered as well. The article proposes that part of the process of obtaining informed consent is the cultivation of a treatment environment that emphasizes beneficence and client autonomy.     

Imaging or imagining? A neuroethics challenge informed by genetics

From a twenty-first century partnership between bioethics and neuroscience, the modern field of neuroethics is emerging, and technologies enabling functional neuroimaging with unprecedented sensitivity have brought new ethical, social and legal issues to the forefront. Some issues, akin to those surrounding modern genetics, raise critical questions regarding prediction of disease, privacy and identity. However, with new and still-evolving insights into our neurobiology and previously unquantifiable features of profoundly personal behaviors such as social attitude, value and moral agency, the difficulty of carefully and properly interpreting the relationship between brain findings and our own self-concept is unprecedented. Therefore, while the ethics of genetics provides a legitimate starting point--even a backbone--for tackling ethical issues in neuroimaging, they do not suffice. Drawing on recent neuroimaging findings and their plausible real-world applications, we argue that interpretation of neuroimaging data is a key epistemological and ethical challenge. This challenge is two-fold. First, at the scientific level, the sheer complexity of neuroscience research poses challenges for integration of knowledge and meaningful interpretation of data. Second, at the social and cultural level, we find that interpretations of imaging studies are bound by cultural and anthropological frameworks. In particular, the introduction of concepts of self and personhood in neuroimaging illustrates the interaction of interpretation levels and is a major reason why ethical reflection on genetics will only partially help settle neuroethical issues. Indeed, ethical interpretation of such findings will necessitate not only traditional bioethical input but also a wider perspective on the construction of scientific knowledge.     

TheoArtistry: practical perspectives on ‘theologically informed art’

ABSTRACT

This article reviews the TheoArtistry Composers’ Scheme (2016–2018), in light of the developing concept of ‘theologically informed art’. Based at the Institute for Theology, Imagination, and the Arts (ITIA) (University of St Andrews), the scheme partnered emerging theologians and composers to create six new choral settings of Hebrew Bible ‘annunciations’. In addition to producing new music, the project became a practical touchstone for reinvigorating dialogues between theologians and practising artists, as well as Christians and non-Christians. First, the author assesses the scheme’s contributions to the study and practice of theologically informed art in the future. Second, she outlines some methodological issues associated with the scheme’s unique breadth of participants. Finally, she assesses ecclesiological and theological ambiguities within the scheme. The author argues that clarifying these ambiguities expands horizons for future collaborations in theologically informed art.     

The logic of ‘being informed’ revisited and revised

The logic of ‘being informed’ gives a formal analysis of a cognitive state that does not coincide with either belief, or knowledge. To Floridi, who first proposed the formal analysis, the latter is supported by the fact that unlike knowledge or belief, being informed is a factive, but not a reflective state. This paper takes a closer look at the formal analysis itself, provides a pure and an applied semantics for the logic of being informed, and tries to find out to what extent the formal analysis can contribute to an information-based epistemology.     

Feedback from research participants: are member checks useful in qualitative research?

It is often assumed that use of so-called “member checks” improves the credibility of qualitative research. Published literature mentioning member checks was reviewed to identify the purposes and procedures for seeking feedback from research participants as well as outcomes reported from member checks. Four themes reflecting underlying assumptions about the purposes of research that have implications for member checks were identified: theory generalisation, representation, participation, and change. Member checks are unlikely to be relevant to research focussed on theory development and generalisation. For other types of research, member checks might be justifiable, but there was little evidence that member checks improved research findings. Member checks can be useful for obtaining participant approval for using quotations or case studies and where anonymity cannot be guaranteed. In evaluation, stakeholder reviews of draft reports can be seen as good research practice. In participatory or collaborative research, ongoing contact might include member checks.     

Are release recommendations for NGRI acquittees informed by relevant data?

We conducted a retrospective review of factors involved in clinical recommendations for release of patients adjudicated not guilty by reason of insanity (NGRI). Medical records from 91 patients in a maximum security forensic hospital who participated in a formal hearing process to determine suitability for release were reviewed. The purpose of the study was twofold: (1) to examine the process involved in day to day clinical decision-making regarding release from a maximum security forensic hospital and (2) to determine what factors in a patient's clinical and legal history were related to recommendation decisions. Multivariate statistical methods revealed that among the clinical, demographic, and legal information available to clinicians at the time a formal release recommendation was made two factors emerged that were significantly related to release recommendations: PCL-R score and the age at which the patient committed his first criminal offense. Patients with high levels of psychopathy and those who engaged in criminal behavior at a younger age were less likely to be recommended for release from a maximum security forensic hospital.     

Intraoperative conversion to open technique: is informed consent implied?

This case raises issues regarding the anesthesia and surgical components of preoperative informed consent and the differing views of anesthesiologists and surgeons with regards to informed consent, in the context of conversion to open surgery from a minimally invasive approach.     

Family therapy research: Comment on “research as a family therapy intervention technique”

Wright's emphasis on and illustration of the use of family therapy research as a unique intervention technique for therapy is an important contribution to the practice literature. Equally important, however, is the isomorphic shift in focus of the family therapy researcher. Rather than focusing only on process or outcome research, family therapists should become more interested in their clients as research subjects. Though rarely discussed in the family therapy literature, the competencies of family therapists as researchers and the utility of research in a family therapy context is critical to being a well-rounded professional. Examples are provided of how this emphasis is being introduced in a PhD family therapy program.