Xu Antonia, Baysari Melissa Therese, Stocker Sophie Lena, Leow Liang Joo, Day Richard Osborne, Carland Jane Ellen
School of Medical Sciences, University of NSW, Sydney, NSW, Australia.
Department of Clinical Pharmacology and Toxicology, St Vincent's Hospital, Darlinghurst, NSW, Australia.
BMC Med Ethics. 2020 Oct 2;21(1):93. doi: 10.1186/s12910-020-00538-7.
Informed consent is often cited as the "cornerstone" of research ethics. Its intent is that participants enter research voluntarily, with an understanding of what their participation entails. Despite agreement on the necessity to obtain informed consent in research, opinions vary on the threshold of disclosure necessary and the best method to obtain consent. We aimed to investigate Australian researchers' views on, and their experiences with, obtaining informed consent.
Semi-structured interviews were conducted with 23 researchers from NSW institutions, working in various fields of research. Interviews were analysed and coded to identify themes.
Researchers reported that consent involved information disclosure, understanding and a voluntary decision. They emphasised the variability of consent interactions, which were dependent on potential participants' abilities and interests, study complexity and context. All researchers reported providing written information to potential participants, yet questioned the readability and utility of this information. The majority reported using signed consent forms to 'operationalise' consent and reported little awareness of, and lack of support in implementing more dynamic informed consent procedures, such as verbal informed consent, that was fit for the purposes of their studies. Views on Human Research Ethics Committees (HRECs) varied. Some reported inconsistent, arduous inputs on the information form and consent process. Others expressed reliance on HRECs for guidance, viewing them as institutional safeguards.
This study highlights the importance of transparent relationships, both between researchers and participants, and between researchers and HRECs. Where the relationship with study participants was reported as more robust, researchers felt that they were better able to ensure participants made better, more informed decisions. Where the relationship with HRECs was reported as more robust, researchers were more likely to view them as institutional safeguards, rather than as bureaucratic hindrances. Conscientious and mindful researchers are paramount to ensuring the procedure accommodates individual requirements. This study advocates that when designing ethical informed consent practices, researchers should be integrated as autonomous players with a positive input on the process, rather than, in the worst case, predatory recruiters to be curtailed by information forms and oversight.
知情同意常被视为研究伦理的“基石”。其目的是让参与者在了解参与研究的具体内容后自愿参与。尽管对于在研究中获得知情同意的必要性已达成共识,但对于所需披露信息的阈值以及获取同意的最佳方法,各方观点不一。我们旨在调查澳大利亚研究人员对于获取知情同意的看法及经历。
对来自新南威尔士州各机构、从事不同研究领域的23名研究人员进行了半结构化访谈。对访谈进行分析和编码以确定主题。
研究人员报告称,同意包括信息披露、理解和自愿决定。他们强调同意互动的多样性,这取决于潜在参与者的能力和兴趣、研究的复杂性及背景。所有研究人员都报告向潜在参与者提供了书面信息,但对这些信息的可读性和实用性表示质疑。大多数人报告使用签署的同意书来“实施同意”,并表示对更具动态性的知情同意程序(如口头知情同意)了解甚少,且在实施适合其研究目的的此类程序时缺乏支持。对人类研究伦理委员会(HRECs)的看法各不相同。一些人报告称,伦理委员会对信息表和同意过程的意见不一致且繁琐。另一些人则表示依赖伦理委员会提供指导,将其视为机构保障。
本研究强调了研究人员与参与者之间以及研究人员与伦理委员会之间透明关系的重要性。当与研究参与者的关系被报告为更稳固时,研究人员认为他们更有能力确保参与者做出更好、更明智的决定。当与伦理委员会的关系被报告为更稳固时,研究人员更有可能将其视为机构保障,而非官僚障碍。认真负责、用心的研究人员对于确保程序适应个体需求至关重要。本研究主张,在设计符合伦理的知情同意实践时,应将研究人员作为自主参与者纳入其中,使其对该过程产生积极影响,而不是在最坏的情况下,将其视为需通过信息表和监督加以限制的掠夺性招募者。