scholarly journals PENEGAKAN OTONOMI PASIEN MELALUI PERSETUJUAN TINDAKAN MEDIS (INFORMED CONSENT)

2013 ◽  
Vol 1 (1) ◽  
Author(s):  
Dionisius Felenditi
Keyword(s):  
Informed Consent ◽  
Medical Treatment ◽  
Personal Autonomy ◽  
Proxy Consent ◽  
Key Words Informed Consent ◽  
Voluntary Consent ◽  
Life Saving ◽  
The Family ◽  
The Guardian ◽  
Extraordinary Means

Abstract: Informed consent is the voluntary consent given by the patient for medical treatment, after he/she has obtained all the necessary information about the possible risks of the treatment. Informed consent is done upon the principle of autonomy, beneficence, and nonmaleficence. This is based on the principle of patient dignity wherein the personal autonomy and integrity of the patient is protected and respected. If the patient is incompetent, the consent will be given by the family, the legal proxy, or the guardian. If the family or the guardian is present but they are also incompetent, then the medical staff themselves must make a decision to determine the appropriate medical treatment in accordance with the patient’s condition. Informed consent is especially needed in extraordinary means. Albeit, for a patient in critical condition or in an emergency wherein the medical treatment must be done immediately as a life-saving procedure, proxy consent is not needed. Key words: informed consent/refusal, autonomy, competence, extraordinary means.     Abstrak: Informed consent ialah persetujuan bebas yang diberikan oleh pasien terhadap suatu tindakan medis, setelah ia memperoleh semua informasi yang penting mengenai sifat serta konsekuensi tindakan tersebut. Informed consent dibuat berdasarkan prinsip autonomi, beneficentia dan nonmaleficentia, yang berakar pada martabat manusia di mana otonomi dan integritas pribadi pasien dilindungi dan dihormati. Jika pasien tidak kompeten, maka persetujuan diberikan oleh keluarga atau wali sah. Jika keluarga/wali hadir tetapi tidak kompeten juga, maka tenaga medis harus memutuskan sendiri untuk melakukan  tindakan medis tertentu sesuai keadaan pasien. Informed consent terutama dibutuhkan dalam kasus-kasus luar biasa (exraordinary means). Namun untuk pasien kritis atau darurat yang harus segera diambil tindakan medis untuk menyelamatkannya, proxy consent tidak dibutuhkan. Kata-kata kunci : persetujuan/penolakan, otonomi, kompetensi, sarana luar biasa.

Understanding voluntariness of consent in first-in-human cell therapy trials

2020 ◽  
Vol 15 (5) ◽  
pp. 1647-1660
Author(s):  
Kristina Hug
Keyword(s):  
Clinical Trials ◽  
Informed Consent ◽  
High Risk ◽  
Cell Therapy ◽  
Human Cell ◽  
Cell Therapies ◽  
Human Trials ◽  
Voluntary Consent ◽  
The Family ◽  
Therapeutic Alternatives

Consensus about contents of voluntariness in informed consent is lacking. Core criteria for voluntary consent are needed to ensure voluntariness. This article outlines the multidimensionality of voluntariness and identifies what could reduce voluntariness, especially in first-in-human clinical trials involving cell therapies. In such trials, truly voluntary consent is especially important because: such trials may involve risk of serious harm, while in case of some diseases, eligible patients often have potentially effective therapeutic alternatives; patients considering participation in high-risk first-in-human trials may feel more desperate and some may be dependent on their caregivers, including those in the family; implanted cells cannot be taken out of the patient's body if the patient wants to withdraw.

scholarly journals INFORMED CONSENTATAS TINDAKAN KEDOKTERAN DI RUMAH SAKIT GRHASIA PAKEM YOGYAKARTA

2014 ◽  
Vol 26 (2) ◽  
pp. 234
Author(s):  
Ninik Darmini ◽  
Rizky Septiana Widyaningtyas
Keyword(s):  
Informed Consent ◽  
Medical Treatment ◽  
Initial Treatment ◽  
Legal Protection ◽  
The Family ◽  
Written Informed Consent

A written informed consent has been given for all medical acts in Ghrasia Hospital. This to be observed such as the juridical force of informed consent which is given at the beginning of the medical treatment, and the legal protection to Ghrasia Hospital Pakem Yogyakarta related to informed consent which is given at the beginning of the medical treatment. This research shows that the informed consent was valid only for medical acts performed as an initial treatment. Moreover, the hospital must tell the family about the medical treatment that has been done. Sebuahinformed consenttertulis diberikan untuk seluruh tindakan kedokteran di Rumah Sakit Ghrasia, menimbulkan dua hal yang perlu diteliti, yaitu: kekuatan yuridis informed consentyang diberikan pada saat permulaan pasien penderita gangguan jiwa akan menjalani perawatan pada Rumah Sakit Grhasia Pakem Yogyakarta dan perlindungan hukum terhadap Rumah Sakit Grhasia Pakem Yogyakarta berkaitan dengan diberikannya informed consentpada saat permulaan pasien penderita gangguan jiwa akan menjalani perawatan. Hasil penelitian menyatakan bahwa: Pertama, informed consenthanya sah untuk tindakan kedokteran yang dilakukan sebagai penanganan awal pasien. Kedua, rumah sakit wajib segera memberitahukan kepada keluarga atas tindakan kedokteran yang telah dilakukan.

Crisis and Informed Consent: Analysis of a Law-Medicine Malocclusion

1987 ◽  
Vol 12 (1) ◽  
pp. 55-97 ◽  
Author(s):  
Fran Carnerie
Keyword(s):  
Informed Consent ◽  
Medical Treatment ◽  
Clinical Setting ◽  
Patient Relationship ◽  
Physician Patient Relationship ◽  
Catastrophic Illness ◽  
Physician Patient ◽  
Emotional Impairment

AbstractMany individuals develop a temporary state of cognitive and emotional impairment after being diagnosed with catastrophic illness. Thus, when crucial decisions about medical treatment are required, they are unable to assimilate information; or worse, the legal need to be informed can rival a psychological desire to not be informed. The Canadian informed consent doctrine is unresponsive to crisis and clinically impracticable, and so paradoxically compromises the integrity and autonomy it was designed to protect. Many aspects of the physician-patient relationship and clinical setting also undermine the philosophical values enshrined in this doctrine. This further jeopardizes the individual's integrity. The Article explores proposals for change such as delaying the informing and consenting, improving the concept of consent, and improving the role of the physician.

Commentary 1: Research with Persons Under Involuntary Commitment—Ethical Issues Surrounding Competence and Voluntariness

2019 ◽  
Vol 14 (5) ◽  
pp. 475-478
Author(s):  
Matthé Scholten ◽  
Jochen Vollmann
Keyword(s):  
Informed Consent ◽  
Ethical Issues ◽  
Research Participation ◽  
Research Participant ◽  
Involuntary Commitment ◽  
Proxy Consent ◽  
Undue Influence ◽  
Research Participants ◽  
Manic Symptoms ◽  
Prospective Research

In this case commentary, we analyze ethical concerns that were raised in response to an interview with a woman with bipolar disorder who was under involuntary commitment. We focus on competence and voluntariness as two prerequisites for valid informed consent. We recommend that judgments of competence be based on whether prospective research participants sufficiently possess certain decision-making abilities. Based on this functional approach, we argue that manic symptoms need not undermine competence and that, even if we were to assume that the research participant became incompetent during the interview, this would not invalidate her consent retroactively. It would, however, compromise her ability to revoke her consent. We furthermore show that obtaining additional proxy consent for research participation may compromise the autonomy of service users who are competent to consent. Then we turn to the issue of voluntariness. Arguing that neither the great strength nor the external etiology of a desire compromises voluntariness, we propose that the voluntariness of a decision instead depends on whether the decision-maker endorses it on reflection. The researchers disclosed that prospective research participants’ decision about study participation would have no influence on the duration of the commitment or the quality of care. We contend that because of this neither coercion nor undue influence was exerted in the informed consent process. Nevertheless, there is an increased likelihood of perceived coercion and undue influence under conditions of involuntary commitment, and we close by suggesting some safeguards to prevent this.

Certified Patient Decision Aids: Solving Persistent Problems with Informed Consent Law

2017 ◽  
Vol 45 (1) ◽  
pp. 12-40 ◽  
Author(s):  
Thaddeus Mason Pope
Keyword(s):  
Decision Making ◽  
Informed Consent ◽  
Medical Treatment ◽  
Shared Decision Making ◽  
Decision Aids ◽  
Shared Decision ◽  
Legal Doctrine ◽  
Patient Decision Aids ◽  
Patient Decision ◽  
Decision Making Processes

The legal doctrine of informed consent has overwhelmingly failed to assure that the medical treatment patients get is the treatment patients want. This Article describes and defends an ongoing shift toward shared decision making processes incorporating the use of certified patient decision aids.

scholarly journals Legal Peculiarities of Child Custody of Minor Parents with an Incomplete Parental Status

2020 ◽  
Vol 6 ◽  
pp. 22-25
Author(s):  
Ekaterina E. Lekanova ◽  
Keyword(s):  
Russian Federation ◽  
Legal Status ◽  
Legal Protection ◽  
Legal Regulation ◽  
Minor Parent ◽  
The Family ◽  
The Russian Federation ◽  
A Minor ◽  
The Guardian ◽  
Family Code

Despite the existence of an article in modern Russian legislation on the legal status of minor parents, many legal issues related to the implementation and protection of the rights, duties, interests of a minor parent and his child remained outside family legal regulation, which exacerbates the already difficult problem of legal protection of early parenthood. Moreover, the provisions of Article 62 of the Family Code of the Russian Federation are very inharmoniously combined with the rules of guardianship of minors. The aim of the work is to analyze the legislation on the legal status of minor parents and guardians, to identify the legal characteristics of the care of a child of minor parents. The author concludes that the features of the care of a child of minor parents, in addition to the age of one or both parents, in the case of the appointment of a guardian include: a combination of parenthood and guardianship; unequal opportunities for the care of a child by a minor parent who is not able to independently provide care, and by the legal representative of the child of the minor parent; special (additional) grounds for terminating guardianship of a child of minor parents; the need for the guardian to live together not only with the child in care, but also with his parent. The norms of paragraph 2 of article 62 of the Family Code of the Russian Federation and paragraph 2 of article 29 of the Federal law «On Guardianship and Custodianship» should be adjusted. It is proposed to introduce special rules for the selection of the guardian of a child of a minor parent, which would properly ensure the right of the minor parent to live together with the child.

scholarly journals Introduction of triage. An experience of a triage nurse in a tertiary centre in Japan

2019 ◽  
pp. 87-89
Author(s):  
Shinobu Tsuge ◽  
Takahiro Shinagawa ◽  
Kumi Hara ◽  
Akio Aihara
Keyword(s):  
Medical Treatment ◽  
Dynamic Process ◽  
Fire Department ◽  
Saving Rate ◽  
Triage Nurse ◽  
Emergency Patients ◽  
Tertiary Centre ◽  
Emergency Medical ◽  
Life Saving

Emergency medical treatment in Japan is subject to jurisdiction by the Fire Department. Triage, by definition, is a dynamic process, as the patient's status can change rapidly. Triage is very important for Japan, where emergency patients are on the rise. The role of triage nurse is also important. That will improve the life-saving rate of emergency patients and improve the reversion to society.

scholarly journals Autonomy, Rationality, and Contemporary Bioethics

2020 ◽  
Author(s):  
Jonathan Pugh
Keyword(s):  
Decision Making ◽  
Informed Consent ◽  
Personal Autonomy ◽  
Rational Beliefs ◽  
Philosophical Work ◽  
Decision Making Capacity ◽  
Important Relationship ◽  
Legal Judgments ◽  
The Relationship ◽  
New Framework

Personal autonomy is often lauded as a key value in contemporary Western bioethics, and the claim that there is an important relationship between autonomy and rationality is often treated as an uncontroversial claim in this sphere. Yet, there is also considerable disagreement about how we should cash out the relationship between rationality and autonomy. In particular, it is unclear whether a rationalist view of autonomy can be compatible with legal judgments that enshrine a patient’s right to refuse medical treatment, regardless of whether ‘… the reasons for making the choice are rational, irrational, unknown or even non-existent’. This book brings recent philosophical work on the nature of rationality to bear on the question of how we should understand autonomy in contemporary bioethics. In doing so, the author develops a new framework for thinking about the concept, one that is grounded in an understanding of the different roles that rational beliefs and rational desires have to play in personal autonomy. Furthermore, the account outlined here allows for a deeper understanding of different forms of controlling influence, and the relationship between our freedom to act, and our capacity to decide autonomously. The author contrasts his rationalist account with other prominent accounts of autonomy in bioethics, and outlines the revisionary implications it has for various practical questions in bioethics in which autonomy is a salient concern, including questions about the nature of informed consent and decision-making capacity.

Father-perpetrators of child sexual abuse who commit suicide

1990 ◽  
Vol 7 (2) ◽  
pp. 144-145 ◽  
Author(s):  
Geraldine Walford ◽  
Marie-Therese Kennedy ◽  
Morna K. C Manwell ◽  
Noel McCune
Keyword(s):  
Sexual Abuse ◽  
Child Sexual Abuse ◽  
Sexually Abused ◽  
Attempted Suicide ◽  
Suicide Attempts ◽  
Recent Letter ◽  
The Family ◽  
Sex Offences ◽  
The Guardian ◽  
The Impact

Two cases of fathers who committed suicide following the revelation that they had sexually abused their own or other children, are described. The importance of being alert to the possibility of suicide and suicidal acts by family members following a disclosure, is emphasised. Improved liaison and co-ordination between agencies working with these families may enable vulnerable cases to be more readily identified and consequently offered appropriate support and treatment.The revelation that the father in a family has sexually abused his own or other children often precipitates a crisis within the family. The distress suffered by the children themselves and by their mothers is well documented. (Browne and Finkelhor, Hildebrand and Forbes). Goodwin reported suicide attempts in 11 of 201 families, in which sexual abuse had been confirmed. Eight of the attempts were made by daughter-victims. In three of the five cases of mothers who attempted suicide, the abuse was intrafamilial. The impact on father perpetrators, previously a less well researched field, has been receiving more attention of late. Maisch, in a sample of 63 fathers convicted of incest reported that two fathers subsequently committed suicide. Wild has reported on six cases of suicide and three of attempted suicide by perpetrators following disclosure of child sexual abuse. The Cleveland Inquiry Report mentions one father, charged with several sex offences, who committed suicide while awaiting trial. A recent letter to The Guardian newspaper (18th February 1989) by 11 local paediatricians in that area suggests that there are now two such cases of suicide committed by alleged perpetrators.

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