Best Practices in Gaining Informed Consent

Informed consent is an important part of any medicalIf the subject is a physician investigator's patient,
research involving humans. Consent means more thansteps need to be taken to ensure the human subject
a simple signature on a form; instead it involves alldoes not feel an obligation or pressure to be part of
steps taken in the protection of human subjects.the trial. The investigator can have a conversation
Physicians in charge of clinical research studies mustwith or send a letter to the potential participant, but
be careful to educate potential subjects so they canhe or she should ask a colleague to follow up with
make a truly informed decision.the patient. Investigators can also have nurses or
Informed consent begins from the first point ofcolleagues introduce the patient to the study to take
contact, which can be a commercial, letter oraway any kind of undue pressure or stress on the
pre-screening call. Those in charge of the clinicalpatient.
research study must be sensitive to keep all theObtaining consent from children or minors has a
information easy to understand and avoid medical anddifferent set of ethical issues and ethical principles
technical jargon. Excessive use of terminology maythan gaining consent from adults. Federal laws
put the patient in danger because he or she does notstipulate that consent must be given by a parent or
understand what is being said, but is toolegal guardian, but many states have different laws
embarrassed to ask for clarification.regarding how many parents need to consent and
After the initial contact, an in-person consenthow to establish legal guardianship. In most cases,
discussion should be arranged. This needs to bewhen the clinical trial involves minimal risk or has
scheduled well in advance of the clinical trial start dategreater than minimal risk but proposed direct benefit
to give the potential human subject time to considerto the child, only one parent needs to consent.
their participation. During this session, give the subjectHowever, when clinical research involves greater than
general information about the clinical trial studies inminimal risk and has no prospect of direct benefit for
which the person can participate.the child, both parents must give their permission If
You will also be reviewing the purpose of thethe other parent is deceased, unknown, incompetent
research, procedures, risks and potential benefits.or reasonably unavailable, you only need to contact
Give the participant a copy of the consent form soone parent. Be especially careful of these
he or she will be able to take it home, read itcircumstances and document your reasons for only
carefully and talk about it with family and a personalspeaking with one parent. Try to obtain
physician. If the person agrees to take part in thedocumentation proving the other parent's death,
research trials, obtain the signed and dated consentincompetence, etc.
form and give the participant a copy.Assent should also be gained from children seven
When there is minimal or more than minimal risk oryears of age and older. Before beginning a discussion
during an investigational device and drug trials, aabout the risks and potential benefits with the child,
licensed physician investigator listed on the protocolinvestigators should assess the potential subject's
should get consent from the human subject. Studymaturity and psychological state. If the investigator
nurses and staff can help in the consent process, butfeels the child will not be able to process the details
the physicians should be actively involved in explainingof the clinical trial, he or she should document why
risks and potential benefits.assent was not pursued.