May I have your permission please?

May I have your permission
The consent process:
What, Where, When, Who and Why
Valerie Smith
OHRP IRB Program Manager
[email protected]
The Farside, by
Gary Larson
The Belmont Report
Ethical Principles and Guidelines for the protection of human subjects of
research (1979)
Basic Ethical Principle
 Respect for Persons. -- Respect for persons incorporates at least two
ethical convictions: first, that individuals should be treated as
autonomous agents, and second, that persons with diminished
autonomy are entitled to protection. The principle of respect for
persons thus divides into two separate moral requirements: the
requirement to acknowledge autonomy and the requirement to protect
those with diminished autonomy.
Application of the basic principle
Informed Consent. -- Respect for persons requires that
subjects, to the degree that they are capable, be given the
opportunity to choose what shall or shall not happen to
them. This opportunity is provided when adequate standards
for informed consent are satisfied.
What does this mean for the researcher-subject relationship?
It means we need to:
 Provide information
 Assess comprehension
 Assure and assess voluntariness
45 CFR 46
General requirements for informed consent
 Researchers must obtain consent from all subjects
 Researchers must provide subjects with adequate time
and opportunity without potential undue influence to
give consent
 Researchers must provide study information in
language understandable to subjects (8th grade or
lower, translation, no jargon or scientific terms unless
 Researchers must not include any language through
which subjects rights might be or appear to be waived
45 CFR 46
Eight Basic Elements of Consent
 A statement that the study involves research, an explanation of
the purposes of the research and the expected duration of the
subject's participation, a description of the procedures to be
followed, and identification of any procedures which are
 A description of any reasonably foreseeable risks or discomforts
to the subject;
 A description of any benefits to the subject or to others which
may reasonably be expected from the research;
 A disclosure of appropriate alternative procedures or courses of
treatment, if any, that might be advantageous to the subject;
45 CFR 46
Eight Basic Elements of Consent
 A statement describing the extent, if any,
to which confidentiality of records
identifying the subject will be maintained;
 For research involving more than minimal
risk, an explanation as to whether any
compensation and an explanation as to
whether any medical treatments are
available if injury occurs and, if so, what
they consist of, or where further
information may be obtained;
45 CFR 46
Eight Basic Elements of Consent
 An explanation of whom to contact for
answers to pertinent questions about the
research and research subjects' rights, and
whom to contact in the event of a researchrelated injury to the subject; and
 A statement that participation is voluntary,
refusal to participate will involve no penalty or
loss of benefits to which the subject is
otherwise entitled, and the subject may
discontinue participation at any time without
penalty or loss of benefits to which the
subject is otherwise entitled.
45 CFR 46
Documentation of Informed Consent
 …informed consent shall be documented by the
use of a written consent form approved by the IRB
and signed by the subject or the subject's legally
authorized representative. A copy shall be given to
the person signing the form.
45 CFR 46
Exceptions to Documentation of Consent
 An IRB may waive the requirement for the investigator to obtain a signed
consent form for some or all subjects if it finds either:
 (1) That the only record linking the subject and the research would be the
consent document and the principal risk would be potential harm resulting from
a breach of confidentiality. Each subject will be asked whether the subject wants
documentation linking the subject with the research, and the subject's wishes
will govern; or
 (2) That the research presents no more than minimal risk of harm to subjects
and involves no procedures for which written consent is normally required
outside of the research context.
 In cases in which the documentation requirement is waived, the IRB may require
the investigator to provide subjects with a written statement regarding the
Some Exceptions to Obtaining Consent
 Large-scale retrospective data studies in which there is no information available
to contact subjects to provide consent
 Cases in which the study design necessitates that the subjects not be aware that
research is being conducted (ethnographic observational studies, studies with
deception or incomplete disclosure)
In these instances, researchers must justify to the IRB why they want to waive
consent. Waiving consent may not be requested or justified simply because it
makes the research easier to conduct.
45 CFR 46
Justification to Waive Consent
An IRB may approve a consent procedure which does not include,
or which alters, some or all of the elements of informed consent
set forth in this section, or waive the requirements to obtain
informed consent provided the IRB finds and documents that:
 (1) The research involves no more than minimal risk to the
 (2) The waiver or alteration will not adversely affect the rights
and welfare of the subjects;
 (3) The research could not practicably be carried out without
the waiver or alteration; and
 (4) Whenever appropriate, the subjects will be provided with
additional pertinent information after participation.
Who, Where, When?
Who, Where, When?
 Laboratory (social behavioral)
 Online survey research
 Clinical research
Education research
Concerns in Obtaining Consent
What should researchers be aware of?
 Emphasis on obtaining consent as a process rather
than one-time event
 Providing information in an accessible manner
 Assessing comprehension of subjects
 Assessing voluntariness and assuring no undue
pressure in the environment or conduct of the
consent process
 Providing for privacy of subjects during consent
process as well as during study conduct
Resources for more information and templates
Social Behavioral Research
Biomedical Research / Exemptions
Valerie Smith, CIP
(775) 327-2370
[email protected]
Nancy Moody, JD, MA, Director
(775) 327-2367
[email protected]
Gwenn Snow, MS, RD, CIP
(775) 784-3506
[email protected]
Valerie Smith, CIP
(775) 327-2370
[email protected]
Valerie Smith
OHRP IRB Program Manager
[email protected]

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