Nicholls Stuart G, Etchegary Holly, Tessier Laure, Simmonds Charlene, Potter Beth K, Brehaut Jamie C, Pullman Daryl, Hayeems Robin Z, Zelenietz Sari, Lamoureux Monica, Milburn Jennifer, Turner Lesley, Chakraborty Pranesh, Wilson Brenda J
School of Epidemiology and Public Health, University of Ottawa and Ottawa Hospital Research Institute (OHRI).
Clinical Epidemiology Unit, Faculty of Medicine, Memorial University, St John's, Newfoundland and Labrador.
Public Health Ethics. 2019 May 4;12(2):158-175. doi: 10.1093/phe/phz003. eCollection 2019 Jul.
Newborn bloodspot screening programs are some of the longest running population screening programs internationally. Debate continues regarding the need for parents to give consent to having their child screened. Little attention has been paid to how meanings of consent-related terminology vary among stakeholders and the implications of this for practice. We undertook semi-structured interviews with parents ( = 32), healthcare professionals ( = 19) and policy decision makers ( = 17) in two Canadian provinces. Conceptions of consent-related terms revolved around seven factors within two broad domains, and . comprised: parent decision authority; voluntariness; parent engagement with decision-making; and the process of enacting choice. comprised: professional responsibilities (including disclosure of information and time to review); parent responsibilities; and the need for discussion and understanding prior to a decision. Our findings indicate that consent-related terms are variously understood, with substantive implications for practice. We suggest that consent procedures should be explained descriptively, regardless of approach, so there are clear indications of what is expected of parents and healthcare professionals. Support systems are required both to meet the educational needs of parents and families and to support healthcare professionals in delivering information in a manner in keeping with parent needs.
新生儿血斑筛查项目是国际上开展时间最长的一些人群筛查项目。关于父母是否需要同意对其子女进行筛查的争论仍在继续。对于同意相关术语在利益相关者之间的含义差异以及这对实践的影响,人们关注甚少。我们在加拿大的两个省份对32名家长、19名医疗保健专业人员和17名政策决策者进行了半结构化访谈。同意相关术语的概念围绕两个广泛领域中的七个因素展开,即“家长决策权限”和“决策过程”。“家长决策权限”包括:家长决策权力;自愿性;家长参与决策;以及做出选择的过程。“决策过程”包括:专业职责(包括信息披露和审查时间);家长职责;以及在做出决定之前进行讨论和理解的必要性。我们的研究结果表明,人们对同意相关术语的理解各不相同,这对实践具有实质性影响。我们建议,无论采用何种方式,同意程序都应以描述性方式进行解释,以便清楚地表明对家长和医疗保健专业人员的期望。需要支持系统来满足家长和家庭的教育需求,并支持医疗保健专业人员以符合家长需求的方式提供信息。