Informed consent?

Having helped around 100 undergrads over the years out together ethics applications for their final year project I have come to the realisation that the system isn’t working. What is the real point of an ethics application? Is it to cover your arse so you don’t get sued or is to make sure that your participants really do know, and understand, what they are letting themselves in for? It seems that ethics’ forms are targeted at the former rather than the latter. Has any undergrad ever expressed a nuanced opinion about the importance of informed consent? Shown an ability to distinguish between anonymous and confidential data? Or, rather, do they think the process is about telling participants where the experiment will be and making sure there are no typos?

Informed consent is everything. And it is a lynch pin in so many decisions in your life. GP prescribed you medication? Have they told you about the most common side effects and the dangerous ones, or told you to read the leaflet when you get home? The latter is not informed consent. Ever been assessed for a minor, or even major, medical procedure to find out minutes before your anaesthetic that the procedure is totally different from what you were originally told? In those few minutes do you really have sufficient time to weight up the pros and cons with the anaesthetist hovering over your shoulder?

I had this occur to me at a dental hospital a few months ago. I went for a consultation to have impacted wisdom teeth out. “Yi’, yip, no problem”. No problem my arse. A couple of minutes before the local anaesthetic I was told the teeth were very hard to get to, they might have to cut into the side of the gum to get to them and, even, drill into my jaw!! But, at the very least, they could get them out. However, the teeth snapped and left the roots behind, which I was subsequently told may require an operation to remove if they caused problems. Oh, and we can see from your scan, that the root of the top tooth is very close to your sinuses, so don’t blow your nose for the next week. Ahem, this is not informed consent. Too busy getting my permission to allow a student to do the procedure rather than actually telling me about stuff I might care about.

It’s like a dodgy salesperson flogging you something completely different to what you paid for. As a consumer you’d be pissed. Next time your doctor tries prescribing something for you, think about whether your decision to take those pills is a truly informed one. And watch out for dentists….

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