Informed consent

Publisher Website
Google Scholar
Abstract
\***|We have received an unprecedented response to our cluster of articles on informed consent. Readers can see from these letters and the previous group that we published that correspondents hold very different views on what policy we should set. Because we think that the voices of patients have not been adequately heard we plan to publish further responses from them. We will also publish brief responses from the two authors who introduced the debate. We plan then to hold a meeting of all interested parties—including researchers, ethicists, and patients—to discuss what policy we should adopt. We hope that that meeting will be able to reach a consensus, but if (as seems likely) it cannot then the editorial team will decide our policy. We will report on the meeting and our decision in the journal.–Editor # The central problem is often poor design and conduct of trials {#article-title-2} Editor—We are concerned about some aspects of the recent articles on consent.1 2 Len Doyal claims that informed consent may not be necessary for three most vulnerable groups: young children, patients with learning difficulties, and unconscious or semiconscious patients. Yet young children (unlike all adult groups) have the protection of their parents' consent, and this should always be respected.3 The other two groups show the limitations of applying Kantian respect for autonomy, designed for property owning 18th century gentlemen, to vulnerable dependent patients. There is an urgent need to agree new ways of making research decisions with and for these minority groups. As is usual in arguments against seeking informed consent, there is a tendency to concentrate on dramatic extremes: patients with severe mental impairment and patients receiving heroic cancer treatment. The development of principles from extremes is dangerous and should be discouraged. Difficulties with relatively small groups should not be used to excuse researchers from requesting the consent of the vast majority of …