Presents a new paradigm for informed consent based on autonomous, reflective, rational, substantially understood medical treatments that are substantially disclosed to the patient. The author redefines the physician-patient relationship as an equal partnership between two individuals with the common goal of improving overall health and well-being. She argues that if this view is acknowledged and practiced by the medical community, it will lesson the burdens of achieving an effective informed consent which is based on an autonomously derived decision by the patient. Annotation copyrighted by Book News, Inc., Portland, OR

Informed consent - the process of communication between a patient or research subject and a physician or researcher that results in the explicit agreement to undergo a specific medical intervention - is an ethical concept based on the principle that all patients and research subjects should understand and agree to the potential consequences of the clinical care they receive. Regulations that govern the attainment of informed consent for treatment and research are crucial to ensuring that medical care and research are conducted in an ethical manner and with the utmost respect for individual preferences and dignity. These regulations, however, often require - or are perceived to require - that informed consent documents and related materials contain language that is beyond the comprehension level of most patients and study participants. To explore what actions can be taken to help close the gap between what is required in the informed consent process and communicating it in a health-literate and meaningful manner to individuals, the Institute of Medicine's Roundtable on Health Literacy convened a one-day public workshop featuring presentations and discussions that examine the implications of health literacy for informed consent for both research involving human subjects and treatment of patients. Topics covered in this workshop included an overview of the ethical imperative to gain informed consent from patients and research participants, a review of the current state and best practices for informed consent in research and treatment, the connection between poor informed consent processes and minority underrepresentation in research, new approaches to informed consent that reflect principles of health literacy, and the future of informed consent in the treatment and research settings. Informed Consent and Health Literacy is the summary of the presentations and discussion of the workshop.

Recent years have seen a growing tendency for social scientists to collect biological specimens such as blood, urine, and saliva as part of large-scale household surveys. By combining biological and social data, scientists are opening up new fields of inquiry and are able for the first time to address many new questions and connections. But including biospecimens in social surveys also adds a great deal of complexity and cost to the investigator's task. Along with the usual concerns about informed consent, privacy issues, and the best ways to collect, store, and share data, researchers now face a variety of issues that are much less familiar or that appear in a new light. In particular, collecting and storing human biological materials for use in social science research raises additional legal, ethical, and social issues, as well as practical issues related to the storage, retrieval, and sharing of data. For example, acquiring biological data and linking them to social science databases requires a more complex informed consent process, the development of a biorepository, the establishment of data sharing policies, and the creation of a process for deciding how the data are going to be shared and used for secondary analysis-all of which add cost to a survey and require additional time and attention from the investigators. These issues also are likely to be unfamiliar to social scientists who have not worked with biological specimens in the past. Adding to the attraction of collecting biospecimens but also to the complexity of sharing and protecting the data is the fact that this is an era of incredibly rapid gains in our understanding of complex biological and physiological phenomena. Thus the tradeoffs between the risks and opportunities of expanding access to research data are constantly changing. Conducting Biosocial Surveys offers findings and recommendations concerning the best approaches to the collection, storage, use, and sharing of biospecimens gathered in social science surveys and the digital representations of biological data derived therefrom. It is aimed at researchers interested in carrying out such surveys, their institutions, and their funding agencies.

When is it appropriate to return individual research results to participants? The immense interest in this question has been fostered by the growing movement toward greater transparency and participant engagement in the research enterprise. Yet, the risks of returning individual research resultsâ€"such as results with unknown validityâ€"and the associated burdens on the research enterprise are competing considerations. Returning Individual Research Results to Participants reviews the current evidence on the benefits, harms, and costs of returning individual research results, while also considering the ethical, social, operational, and regulatory aspects of the practice. This report includes 12 recommendations directed to various stakeholdersâ€"investigators, sponsors, research institutions, institutional review boards (IRBs), regulators, and participantsâ€"and are designed to help (1) support decision making regarding the return of results on a study-by-study basis, (2) promote high-quality individual research results, (3) foster participant understanding of individual research results, and (4) revise and harmonize current regulations.

Informed consent - as an ethical ideal and legal doctrine - has been the source of much concern to clinicians. Drawing on a diverse set of backgrounds and two decades of research in clinical settings, the authors - a lawyer, a physician, a social scientist, and a philosopher - help clinicians understand and cope with their legal obligations and show how the proper handling of informed consent can improve , rather than impede, patient care. Following a concise review of the ethical and legal foundations of informed consent, they provide detailed, practical suggestions for incorporating informed consent into clinical practice. This completely revised and updated edition discusses how to handle informed consent in all phases of the doctor-patient relationship, use of consent forms, patients' refusals of treatment, and consent to research. It comments on recent laws and national policy, and addresses cutting edge issues, such as fulfilling physician obligations under managed care. This clear and succinct book contains a wealth of information that will not only help clinicians meet the legal requirements of informed consent and understand its ethical underpinnings, but also enhance their ability to deal with their patients more effectively. It will be of value to all those working in areas where issues of informed consent are likely to arise, including medicine, biomedical research, mental health care, nursing, dentistry, biomedical ethics, and law.

Most Asian cities have grown more congested, more sprawling, and less livable in recent years; and statistics suggest that this trend will continue. Rather than mitigate the problems, transport policies have often exacerbated them. In this book, the Asian Development Bank outlines a new paradigm for sustainable urban transport that gives Asian cities a workable, step-by-step blueprint for reversing the trend and moving toward safer, cleaner, more sustainable cities, and a better quality of urban life.

This volume reflects the development and theoretical foundation of a new paradigm for critical thinking based on inquiry. The field of critical thinking, as manifested in the Informal Logic movement, developed primarily as a response to the inadequacies of formalism to represent actual argumentative practice and to provide useful argumentative skills to students. Because of this, the primary focus of the field has been on informal arguments rather than formal reasoning. Yet the formalist history of the field is still evident in its emphasis, with respect to both theory and pedagogy, on the structure and evaluation of individual, de-contextualized arguments. It is our view that such a view of critical thinking is excessively narrow and limited, failing to provide an understanding of argumentation as largely a matter of comparative evaluation of a variety of contending positions and arguments with the goal of reaching a reasoned judgment on an issue. As a consequence, traditional critical thinking instruction is problematic in failing to provide the reasoning skills that students need in order to accomplish this goal. Instead, the goal of critical thinking instruction has been seen largely as a defensive one: of learning to not fall prey to invalid, inadequate, or fallacious arguments.

This title was first published in 2003. The fulfilment of health care rights in a world where resources are scarce is a prominent issue. In this volume, Frances H. Miller introduces studies on a wide variety of aspects of this important yet complex process.

It is generally accepted in legal and bioethical discourse that the patient has a right to self-determination. In practice though, this is often not the case. Paternalism is waning and it is increasingly recognised that there are values other than medical factors which determine the choices that patients make. Unfortunately, these developments have not resulted in huge advances for patient self-determination, which is largely because the consent model has fundamental flaws that constrain its effectiveness. This book sets out to offer an alternative model to consent. In the property model proposed here, the patient’s bodily integrity is protected from unauthorised invasion, and their legitimate expectation to be provided with the relevant information to make an informed decision is taken to be a proprietary right. It is argued that the property model potentially overcomes the limitations of the consent model, including the obstacle caused by the requirement to prove causation in consent cases. The author proposes that this model could in the future provide an alternative or complementary approach for the courts to consider when dealing with cases relating to self-determination in health care.

This volume gathers the contributions of leading researchers in the fields of bioethics, medical law and human rights. By providing an interdisciplinary reading of advance directives regulation against the background of European and International law, this book aims to offer new insights into the most controversial legal issues surrounding the theme of dignity and autonomy at the end of life. Cross-cultural perspectives from Europe, the Americas, Australia and China offer a comparative analysis of legal approaches to end-of-life decision-making and care, including the hotly debated issues of euthanasia and assisted suicide, also giving an account of recent developments in domestic legislation and jurisprudence. Special focus is placed on the Italian legal system and its ongoing discussion on advance directives regulation.