INFORMED CONSENT IN BIO-MEDICAL RESEARCH INVOLVING HUMAN PARTICIPANTS Selina khatun MPH, Mphil Lecturer(Anatomy Department) MMC INFORMED CONSENT Concept and Importance Historical Background Obtaining Informed Consent: Elements for Informed Consent Essential Information for prospective participants. Procedure Exceptions Informed Consent Form CONCEPT OF INFORMED COSENT ˚ Medical advances should not require some people to sacrifice their health and rights for the good of all. ˚ Informed consent is a process which is designed to empower the individual to make a voluntary informed decision regarding participation in the research. ˚ Voluntary consent means that the participants were able to consent, were not being coerced to do the study and understood the risks and benefit involved. Informed Consent ˚ Informed consent is a key instrument in protecting the right. ˚ Procurement of consent ensures human dignity of the participants and also shows respect for them. ˚ Informed consent is one of the primary ethical principles governing human subject research. ˚ Informed consent assures that prospective research subjects will understand the nature of the research and can knowledgeably and voluntarily decide whether or not to participate Informed Consent ˚ The fundamental ethical duty of respect for persons requires that we do not act against a person’s wishes, and thus genuine consent to participate in research must be obtained. Informed Consent ˚ Why get informed consent? - Respect for person; Autonomy - Justice Informed Consent ˚ Importance of Informed Consent. - Informed Consent is the first and longest of the 10 principles in the Nuremberg code. - Informed Consent is included in every guidelines on Research Ethics. - Informed Consent is one of the 8 requirements for clinical research. Informed Consent ˚ Informed Consent allows individuals: - To determine whether participating in research fits with their values and interests. - To decide whether to contribute to this specific research project. - To protect themselves from risks. - To decide whether they can fulfill the requirements necessary for the research. HISTORICAL BACKGROUND OF INFORMED CONSENT Early References 1891- Prussian Minister of Interior , tuberculin for the treatment of tuberculosis must not be used against a person’s will. 1898- Dr. Albert Neisser was fined by the Royal disciplinary court of Prussia for not seeking patient’s consent for his experimental studies of vaccination for Syphilis. 1907- Sir Willium Osler endorsed the necessity of informed consent in medical research. 1931- Health Department regulations of German Reich stated that both human experimentation and the use of novel treatment required consent in a clear and undebatable manner. World war-II and unethical clinical trials done by US Health Services gave birth of Bioethics. Creation of IRB and notion of Informed Consent. - During World War –II - In Nazis Concentration camp and in America and Britain - President F. Roosevelt-Office of Scientific research to combat Dyscentry, Influenza, Malaria - Use orphan, mentally retarded, psychotic patients - Penicillin to prisoners to settle the dose. - Attitude was different - NIH- funds for experimentation, No right for participants. - 1945-1966 NIH funded 2000 research projects, none of them use informed consent - Thalidomide- Birth defects - Amendment to FD and cosmetic acts. - June 16th,1966. Henry Beecher- NEJM, describe 22 examples done on vulnerable group. - IRB(1960)+ FDA - Tuskegee Syphilis study 1932-1972 - 1997:President Clinton apologized - (1960-1970) - National Research Act - National Commission for protection of research participants in Biomedical and Behavioral Research. - 1979,Belmont Report Belmont Report º Expanded the definition of Informed consent. º Participants-kept experiment, informed º Understand risks and benefits. º Protection of vulnerable group. throughout the