Displaying publications 1 - 20 of 85 in total

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  1. Yusof MYPM, Teo CH, Ng CJ
    BMC Med Ethics, 2022 Nov 21;23(1):117.
    PMID: 36414962 DOI: 10.1186/s12910-022-00849-x
    BACKGROUND: The research shows a growing trend in using an electronic platform to supplement or replace traditional paper-based informed consent processes. Instead of the traditionally written informed consent document, electronic informed consent (eConsent) may be used to assess the research subject's comprehension of the information presented. By doing so, respect for persons as one of the research ethical principles can be upheld. Furthermore, these electronic methods may reduce potential airborne infection exposures, particularly during the pandemic, thereby adhering to the beneficence and nonmaleficence principle. This scoping review aims to identify the ethics related criteria that have been included in electronic informed consent processes and to synthesize and map these criteria to research ethics principles, in order to identify the gaps, if any, in current electronic informed consent processes.

    METHODS: The search was performed based on internet search and three main databases: PubMed, SCOPUS and EBSCO. PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation guideline was used to report this work.

    RESULTS: Of 34 studies that met the inclusion criteria, 242 essential original constructs were collated, and 7 concepts were derived. Digital content showed the highest percentage of collated original constructs (27%, n = 65) followed by accessibility (24%, n = 56), comprehension engagement (18%, n = 43), autonomy (14%, n = 34), confidentiality (11%, n = 25), language (5%, n = 13), and parental consent (1%, n = 2). Twenty-five new items were synthesized for eConsent criteria which may provide guidance for ethical review of research involving eConsent.

    CONCLUSION: The current study adds significant value to the corpus of knowledge in research ethics by providing ethical criteria on electronic informed consent based on evidence-based data. The new synthesized items in the criteria can be readily used as an initial guide by the IRB/REC members during a review process on electronic informed consent and useful to the future preparation of a checklist.

    Matched MeSH terms: Informed Consent*
  2. Mathiharan K
    Natl Med J India, 2014 Jan-Feb;27(1):39-42.
    PMID: 25403126
    The concept of informed consent specific to medical research and treatment is still alien to many medical researchers and practitioners and to millions of Indians. The doctor-patient relationship in India is governed more by trust where the doctor is the authoritative person. Therefore, the benefit of informed consent does not reach all patients in day-to-day medical practice. To complicate the issue, the Indian law is not specific about the age at which a person can give valid consent. The Indian Penal Code is silent about the legal validity of consent given by persons between 12 and 18 years of age. Similarly, the age at which the 'Right to Confidentiality' begins is yet to be defined either by the statute or by the courts. Hence, there is a need for a clear statutory provision to remove the anomalies and ambiguities regarding the age of consent to undergo invasive therapeutic or investigative procedures, participate in clinical trials, as well as define the age at which a person's right to medical confidentiality begins.
    Matched MeSH terms: Informed Consent/legislation & jurisprudence*
  3. Rathor MY, Rani MF, Shah AM, Akter SF
    Med J Malaysia, 2011 Dec;66(5):423-8.
    PMID: 22390094 MyJurnal
    Informed consent [IC] is a recognized socio-legal obligation for the medical profession. The doctrine of IC involves the law, which aims to ensure the lawfulness of health assistance and tends to reflect the concept of autonomy of the person requiring and requesting medical and/or surgical treatment. Recent changes in the health care delivery system and the complex sociological settings, in which it is practiced, have resulted in an increase in judicial activity and medical negligence lawsuits for physicians. While IC is a well-established practice, it often fails to meet its stated purpose. In the common law, the standard of medical care to disclose risks has been laid down by the Bolam test- a familiar concept to most physicians, but it has been challenged recently in many jurisdictions. This paper aims to discuss some important judgments in cases of alleged medical negligence so as to familiarize doctors regarding their socio-legal obligations. We also propose to discuss some factors that influence the quality of IC in clinical practice.
    Matched MeSH terms: Informed Consent/legislation & jurisprudence*; Informed Consent/ethics*
  4. Talib N
    Med Law, 2010 Sep;29(3):433-42.
    PMID: 22145562
    The doctrine of informed consent has the effect of allowing the mentally competent adult patient to exercise individual choice in any proposed medical treatment. The ethical principles primarily inherent in this doctrine would be the principles of autonomy and beneficence. However, it is argued in this essay that the concept and meaning of autonomy might be vastly different between western and eastern communities. Consequently the doctrine of informed consent will lead to a different meaning in these different societies. The essay also raises the implication of transplanting legal doctrines into societies which might not be fully prepared to implement the ideal contained in the doctrine of informed consent.
    Matched MeSH terms: Informed Consent/legislation & jurisprudence*
  5. Matta AM
    Med Law, 2006 Jun;25(2):319-39.
    PMID: 16929809
    The author reviews the legal theory and practice of the requirements for informed consent. He uses a discussion of relevant cases and judgements from courts in the UK, USA, Australia and Malaysia to illustrate apparently conflicting attitudes exemplified by these cases. From this he aims to form some consensus in their application to everyday practice.
    Matched MeSH terms: Informed Consent/legislation & jurisprudence*
  6. Citation:
    Guidelines on health research involving minors. Kuala Lumpur: National Institute of Health, Ministry of Health Malaysia; 2011 [MREC DOC.01-2010]
    Matched MeSH terms: Informed Consent; Informed Consent By Minors
  7. Lydia Aiseah Ariffin
    MyJurnal
    Informed consent has been recognised as an essential part of clinical practice, giving ethical and legal legitimacy to medical intervention. There is no universal standard on the amount and type of information that a patient is entitled to and needs to be adequately disclosed. This article proposes nine information that will assist the doctor in providing adequate information for a patient to evaluate whether to authorise medical intervention. The recommended infor- mation are: (i) diagnosis, prognosis and its uncertainties; (ii) nature of proposed medical intervention; (iii) the expect- ed benefit of proposed medical intervention; (iv) the potential risk of proposed medical intervention; (v) alternative to proposed medical intervention; (vi) progress of proposed medical intervention; (vii) opportunity for a second medical opinion and to seek further details; (viii) costs of proposed and alternative medical intervention; and (ix) the person responsible for implementing medical intervention.
    Matched MeSH terms: Informed Consent
  8. Sivalingam N
    Med J Malaysia, 2011 Dec;66(5):421-2.
    PMID: 22390093 MyJurnal
    Matched MeSH terms: Informed Consent*
  9. Che Ngah A
    J Int Bioethique, 2005 Mar-Jun;16(1-2):143-61, 199.
    PMID: 16637139 DOI: 10.3917/jib.161.0143
    The right of a person to control his body is a concept that has long been recognized in Malaysia under the law of torts. The purpose of requiring informed consent is to preserve that right in medical decision-making. Informed Consent is a relatively new concept in medical litigation cases. However in the late 1990's, it has become one of the important claims under negligence made against the doctor for failure to disclose relevant information to patients in respect of the treatment proposed. Whether Malaysia has begun to recognize patient's right to decision-making is yet to be seen. Furthermore the social-cultural relationship between doctors and patients had to be considered. In this respect, the researcher had conducted interviews with doctors and patients to gauge their reaction towards a shared process of decision-making, which is the central issue in the doctrine of informed consent. Findings suggest that in society where primary health care is the main thrust to achieve health for all, the possibility of recognition of the rights of patients to receive information before making decisions about treatment appears remote. The findings also underscore the importance of incorporating aspects of informed consent as part of providing quality service to patients.
    Matched MeSH terms: Informed Consent/legislation & jurisprudence*
  10. Noor Sam A, Asma A
    Sains Malaysiana, 2012;41:1051-1056.
    A good adhesive is an important factor to consider in orthodontic bonding. Frequent bracket failure prolongs treatment duration and causes inconvenience to patient and operator. This study aimed to compare the effectiveness of two bonding agents, i.e. the self etching primer (SEP) and the conventional etch and bond (CEB) by monitoring the incidence, time and
    sites of bracket failure. Eighty orthodontic patients were recruited after informed consent were obtained. A randomized split mouth technique was used where one side was bonded with CEB agent, while the other side was bonded using SEP agent. All bonded brackets were examined every 4 weeks for 20 months. Incidence of bracket failure was noted and
    comparison between the two groups was done using paired t-test. Time and frequent site of failure were also assessed. Out of 1314 brackets, only 33 brackets were debonded with 16 from SEP group and 17 from CEB group which statistically insignificant (p>0.05). Almost 55% of bracket failure occurred during the first 3 months after bonding for both adhesives
    with lower premolars was most the frequent site to fail in both adhesives (39.4%). Bracket bonded on the left side failed significantly compared to the right side. In conclusion, both self-etching primer and conventional acid-etch bonding agents are equally effective in retaining brackets clinically. Bracket failure mostly occurres during the first 3 months after bonding. The premolar brackets and the left side are mostly debonded when compared to other sites.
    Matched MeSH terms: Informed Consent
  11. Fesol SFA, Arshad MM
    Data Brief, 2020 Dec;33:106421.
    PMID: 33102666 DOI: 10.1016/j.dib.2020.106421
    This paper presents the dataset of undergraduates learning habits during and before the occurrence of pandemic COVID-19 under the scope of sociodemographic and psychological aspects. This dataset consists of four (4) main sections which are students' demographic, psychological disruption, students' learning habits and integration of online sessions with sustainability topics. A total of 37 variables were distributed via an online survey platform. The link of the online survey was circulated to the students using few social media platforms such as WhatsApp groups, Telegram, and faculties' Facebook starting from June 1 until June 31, 2020. There was a total of 668 respondents accompanied by consent were agreed to join the survey. This dataset can have an important role for research and education in identifying the impact on learning performance among the undergraduate students during COVID-19 pandemic based on different sociodemographic and psychological aspects.
    Matched MeSH terms: Informed Consent
  12. Jha N, Shankar PR, Palaian S
    Risk Manag Healthc Policy, 2021;14:793-802.
    PMID: 33658875 DOI: 10.2147/RMHP.S291025
    Background: Medicines may remain unused and often get expired. Unused medicines can promote self-medication. Unsafe and improper medicine disposal can cause significant environmental harm. Medical and dental students as future prescribers should be aware of the safe disposal of medicines, ecopharmacovigilance and self-medication. The present study examines knowledge and practice about unused and expired medicines and medicine disposal among undergraduate medical and dental students in Nepal.

    Methods: The study was conducted during September 2020 using an online survey form. First to final year undergraduate students provided their consent and signed an integrity pledge electronically. Age, gender, program of study, year of study, whether staying with family or not, method of financing education, and whether they had used any allopathic medicines during the past 6 months were noted. The total knowledge score among different subgroups was compared. The frequency of responses regarding practice items and the free-text comments were also listed. Statistical analysis was performed using Mann-Whitney test and Kruskal-Wallis test.

    Results: Altogether 441 of the 668 students (66%) participated. The majority were below 23 years and female. Over 65% had used allopathic medicines during the last 6 months. The median knowledge score was 8 (maximum 10) and was significantly higher among older respondents, females and students in later years of study. Most kept unused medicines at home/hostel till expiry which were disposed of in the household garbage. Over 40% had educated their family members about safe medicine disposal. Knowledge scores were significantly different among subgroups according to respondents' age, gender and year of study.

    Conclusion: Respondents were aware of expiry of medicines and knew methods to safely dispose expired medicines. However, they practiced self-medication, stored medications at home and did not practice the safe disposal of medications. Understanding why respondents did not dispose medicines properly is important.

    Matched MeSH terms: Informed Consent
  13. Abdul Aziz MF, Mohd Yusof AN
    Asian Bioeth Rev, 2019 Jun;11(2):209-222.
    PMID: 33717312 DOI: 10.1007/s41649-019-00086-2
    As with many other countries, Malaysia is also developing and promoting biomedical research to increase the understanding of human diseases and possible interventions. To facilitate this development, there is a significant growth of biobanks in the country to ensure continuous collection of biological samples for future research, which contain extremely important personal information and health data of the participants involved. Given the vast amount of samples and data accumulated by biobanks, they can be considered as reservoirs of precious biomedical big data. It is therefore imperative for biobanks to have in place regulatory measures to ensure ethical use of the biomedical big data. Malaysia has yet to introduce specific legislation for the field of biobanking. However, it can be argued that its existing Personal Data Protection Act 2010 (PDPA) has laid down legal principles that can be enforced to protect biomedical big data generated by the biobanks. Consent is a mechanism to enable data subjects to exercise their autonomy by determining how their data can be used and ensure compliance with legal principles. However, there are two main concerns surrounding the current practice of consent in biomedical big data in Malaysia. First, it is uncertain that the current practice would be able to respect the underlying notion of autonomy, and second, it is not in accordance with the legal principles of the PDPA. Scholars have deliberated on different strategies of informed consent, and a more interactive approach has recently been introduced: dynamic consent. It is argued that a dynamic consent approach would be able to address these concerns.
    Matched MeSH terms: Informed Consent
  14. Peter Gan Kim Soon, Sanjay Rampal, Lim Soo Kun, Tin Tin Su
    MyJurnal
    Introduction: Kidney transplantation (KT) is the preferred end-stage renal disease (ESRD) treatment because it pro-vides a better survival rate, quality of life as well as a cheaper alternative. However, Malaysia’s KT rates is consis-tently low considering that ESRD rates have been increasing exponentially. With only four hospitals performing KT, there’s a gap to indicate a lack of evaluation in KT system of Malaysia. Qualitative study was undertaken to explore and describe the barriers and solutions improve the rates and service of KT in Malaysia. Methods: Semi-structured interviews adopted as qualitative methodological approach to explore current KT policy and service in Malaysia be-tween March – May 2018 in Kuala Lumpur. Eight key-informants selected using stakeholder analysis and informed consent were obtained. Interviews were digitally audio-recorded, transcribed verbatim and analysed using thematic analysis. Results: Barriers and solutions of Malaysia’s KT are the results of complex interplay of personal, cultural, and environmental factors that can be categorized and described using the five levels of influence conceptualized by the socio-ecological model (SEM). Guidance for developing culturally appropriate and sensitive interventional strategies was elicited from the key informants’ experiences to improve KT rate and services in Malaysia. Conclusion:Malaysia is experiencing very low rate of KT compared to other countries. The use of SEM provided a framework to foster a better understanding of current practice, barriers and solutions to KT in Malaysia. Implications of these find-ings could prompt policy change for better KT service delivery model. Further stakeholder engagement and evalua-tion is required to align best practices to improve KT rates and service in Malaysia that is comparable to high-income countries.
    Matched MeSH terms: Informed Consent
  15. Mazlinda Musa, Segaran Ramodran, Floreta Yusop, Nur Shiela Abdul Majid, Nur Fatihah, Aqilah Roslin, et al.
    MyJurnal
    Introduction: Nursing is an emotionally stressful occupation where nurses themselves are at risk of internalizing negative emotions when caring for patients who are suffering, in pain, anguish, and facing death. Studies indicate an individual`s ability to emotionally express or vent these internalize negative emotions is associated with intrinsic happiness and well-being. Similarly, in the context of UMS, student nurses are at times exposed to overwhelming negative emotions during clinical postings and raise the question to what extent students use emotional expressive- ness to vent such emotions. This study is to assess perceived happiness and emotional expressiveness and determine correlates of these attributes among student nurses in UMS. Methods: This study entails a cross-sectioned design involving 90 (N) participants selected through convenient stratified sampling from 1st year (n=30), 2nd year (n=30) and 3rd year (n=30) student nurses. Ethical clearance for this study was obtained from REC UMS and the respon- dent’s consent. Two validated instruments, the Intrinsic Happiness Index (IHI, with 10 Likert scaled items, α =0.78) and Emotional Expressiveness Scale (EES, 17 Likert scaled item α =0.82) were used in this study. Results: Among 90 nursing students in this study, 81%(n=72) scored high and 19% (n=18) scored low in the happiness index. On emotional expressiveness ratings, 68% scored high with 32% scoring low. Higher happiness index scores correlated positively with high emotional expressive scores. First year students had significantly higher perceived happiness score (p=0.02) and higher emotional expressiveness score (p=0.03) compared to 2nd or 3rd-year students. Conclu- sion: Finding in this study imply that although the majority of student had good emotional disposition, but a small percentage of students have lower perceived happiness and emotional expressiveness, which may affect long term psychological well-being. This paper will discuss some remedial strategies to address the issue.
    Matched MeSH terms: Informed Consent
  16. Das AK, Okita T, Enzo A, Asai A
    Asian Bioeth Rev, 2020 Jun;12(2):103-116.
    PMID: 33717332 DOI: 10.1007/s41649-020-00114-6
    The use of single-use items (SUDs) is now ubiquitous in medical practice. Because of the high costs of these items, the practice of reusing them after sterilisation is also widespread especially in resource-poor economies. However, the ethics of reusing disposable items remain unclear. There are several analogous conditions, which could shed light on the ethics of reuse of disposables. These include the use of restored kidney transplantation and the use of generic drugs etc. The ethical issues include the question of patient safety and the possibility of infection. It is also important to understand the role (or otherwise) of informed consent before reuse of disposables. The widespread practice of reuse may bring down high healthcare costs and also reduce the huge amount of hospital waste that is generated. The reuse of disposables can be justified on various grounds including the safety and the cost effectiveness of this practice.
    Matched MeSH terms: Informed Consent
  17. Victor Lim
    MyJurnal
    Consent is defined as the “voluntary agreement to or acquiescence in what another person proposes or desires”. In the context of medical practice it is now universally accepted that every human being of adult years and of sound mind has the right to determine what shall be done with his or her own body. Informed consent is now a central part of medical ethics and medical law. There has been a change in the public’s expectations of their role in medical decision making. The paternalistic approach by doctors is no longer acceptable. Today the patient has the right to receive and the doctor the obligation to give sufficient and appropriate information so that the patient can make an informed decision to accept or refuse a treatment option. This has led to higher standards of practice in the process of informed consent taking. Consent taking is both a legal and moral requirement. Failure to comply with standards of practice can result in criminal prosecution, civil litigation or disciplinary action by the relevant professional authority. Consent taking is a process and not merely a one-off affixation of the patient’s signature on consent form. It involves a continuous discussion to reflect the evolving nature of treatment from before the treatment is given to the post-operative or discharge period. The regulatory authorities in many countries have established standards for consent taking which would include the capacity of the patient, the person who should seek consent, the information to be provided and the necessary documentation.
    Matched MeSH terms: Informed Consent
  18. Aamer Naseer, Humayun Iqbal Khan, Mian Jawad Ahmad, Rabia Tariq, Atif Amin Baig
    MyJurnal
    Objective: To compare the mean duration of diarrhea between children taking yogurt and with the group taking commercial probiotics, containing lactobacillus in acute watery diarrhea. Materials and

    Methods: This descriptive study was conducted in the Department of Pediatrics, Services Hospital, Lahore. The duration of this cross sectional study was 6 months, from June 2013 to November 2013. A total of 200 children suffering from acute watery diarrhea were involved in the study after the informed consent under the said hospital. Their demographic information was recorded and later divided in two groups of 100 each; group A received yogurt and group B was given commercial probiotic. The duration of diarrhea was observed in both groups. The results were compared by using independent sample t-test.

    Results: The average duration of diarrhea in group A, was 1.98 + 1.31 day while that in group B was 3.09 + 1.64 days. Student's t-test was applied and the difference between the two groups was found to be statistically significant (p< 0.05).

    Conclusions: Treatment with yogurt significantly decreases the mean duration of diarrhea as compared to probiotic among patients with acute watery diarrhea.
    Matched MeSH terms: Informed Consent
  19. Yuhanif Yusof, Anisah Che Ngah, Zaki Morad Mohamad Zaher
    Int J Public Health Res, 2014;4(1):384-390.
    MyJurnal
    Introduction The aim of this study was to examine the aspect of information disclosure by doctor-investigator during the process of obtaining informed consent in clinical trials.
    Methods This research employed a mixed-method data collection that is library research and interview. A qualitative methodology and analysis were used in an open-ended, face-to-face interviews with 17 patient-subjects. The interview questions were based on information that needed to be disclosed to patient-subjects during the process of obtaining informed consent. Each interview took place in Kajang Hospital and National Heart Institute and lasted 25-30 minutes. Interviews were conducted in Bahasa Melayu and English. The interviews were tape-recorded, and the main points from the interviews were jotted down to ensure that all information was adequately gathered. Interviewed occurred in Kajang Hospital and National Heart Institute. The participants were patients who had been referred to the Kajang Hospital and National Heart Institute. They were recruited (8 from Kajang Hospital and 9 from National Heart Institute) by their own doctors to participate in a study to evaluate the safety and effectiveness of the investigational stent after been diagnosed with coronary artery disease and also in a study to investigate drug for antidepressant. respectively.
    Results The study revealed that doctor-investigators fail to disclose full information to patient-subjects. Instead, doctor-investigators only disclosed information which they thought were necessary for the patient-subjects to know. The study also showed that there were doctor-investigators who did not disclose information at all to the patient-subjects.
    Conclusions This study implies that the aspect of information disclosure in the process of obtaining informed consent in clinical trials is rather poor and did not fulfill the criterion of good medical practice. A random monitoring task to be conducted by the research ethics commitees during the informed consent process is suggested.
    Matched MeSH terms: Informed Consent
  20. Law ZK, Appleton JP, Scutt P, Roberts I, Al-Shahi Salman R, England TJ, et al.
    Stroke, 2022 Apr;53(4):1141-1148.
    PMID: 34847710 DOI: 10.1161/STROKEAHA.121.035191
    BACKGROUND: Seeking consent rapidly in acute stroke trials is crucial as interventions are time sensitive. We explored the association between consent pathways and time to enrollment in the TICH-2 (Tranexamic Acid in Intracerebral Haemorrhage-2) randomized controlled trial.

    METHODS: Consent was provided by patients or by a relative or an independent doctor in incapacitated patients, using a 1-stage (full written consent) or 2-stage (initial brief consent followed by full written consent post-randomization) approach. The computed tomography-to-randomization time according to consent pathways was compared using the Kruskal-Wallis test. Multivariable logistic regression was performed to identify variables associated with onset-to-randomization time of ≤3 hours.

    RESULTS: Of 2325 patients, 817 (35%) gave self-consent using 1-stage (557; 68%) or 2-stage consent (260; 32%). For 1507 (65%), consent was provided by a relative (1 stage, 996 [66%]; 2 stage, 323 [21%]) or a doctor (all 2-stage, 188 [12%]). One patient did not record prerandomization consent, with written consent obtained subsequently. The median (interquartile range) computed tomography-to-randomization time was 55 (38-93) minutes for doctor consent, 55 (37-95) minutes for 2-stage patient, 69 (43-110) minutes for 2-stage relative, 75 (48-124) minutes for 1-stage patient, and 90 (56-155) minutes for 1-stage relative consents (P<0.001). Two-stage consent was associated with onset-to-randomization time of ≤3 hours compared with 1-stage consent (adjusted odds ratio, 1.9 [95% CI, 1.5-2.4]). Doctor consent increased the odds (adjusted odds ratio, 2.3 [1.5-3.5]) while relative consent reduced the odds of randomization ≤3 hours (adjusted odds ratio, 0.10 [0.03-0.34]) compared with patient consent. Only 2 of 771 patients (0.3%) in the 2-stage pathways withdrew consent when full consent was sought later. Two-stage consent process did not result in higher withdrawal rates or loss to follow-up.

    CONCLUSIONS: The use of initial brief consent was associated with shorter times to enrollment, while maintaining good participant retention. Seeking written consent from relatives was associated with significant delays.

    REGISTRATION: URL: https://www.isrctn.com; Unique identifier: ISRCTN93732214.

    Matched MeSH terms: Informed Consent
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