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Informed consent problems persist in teaching hospitals

NEW YORK, NY - SEPTEMBER 24: Ugandan President Yoweri Kaguta Museveni addresses the U.N. General Assembly on September 24, 2013 in New York City.
Photo by Pool/Getty Images

Despite the existence of the Nuremberg Code (first promulgated in 1949) and the Helsinki Declaration (adopted by the World Medication Association in 1964), clinical trials and even care for non-trial participants admitted to teaching hospitals around the world involves egregious ethical lapses. Recently published research by a team in Uganda uncovers particular lapses in the practice of informed consent in surgical units in teaching hospitals.

"Informed consent in medical practice is essential and a global standard that should be sought at all times that doctors interact with patients," the researchers write. However, they note, "to our knowledge there has not been any systematic review of consent practices to document best practices and identify areas that need improvement." In order to contribute to this body of knowledge, the research team, headed by Joseph Ochieng of the School of Biomedical Sciences at Makerere University in Uganda, studied the informed consent practices in use at three teaching hospitals in Uganda.

What the researchers found disturbed them. Fewer than half of the respondents to the researchers' survey reported that they obtained consent each time that surgery is performed. In addition, more than one-third of the survey respondents did not know the definition of informed consent. Many of the consent forms were signed upon the patients' admission to the hospital, prior to any diagnosis or recommendation of a treatment plan. "There is need for development of an informed consent template," the scientists write, "with adequate information and room for modification to facilitate the informed consent process."

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