J Korean Acad Nurs Adm.  2017 Jun;23(3):223-228. 10.11111/jkana.2017.23.3.223.

Informed Consent: A Complex Process in Iran's Nursing Practice

• Nasrabadi
• Shali M

• KMID: 2386835
• DOI: http://doi.org/10.11111/jkana.2017.23.3.223

Abstract

Informed consent should not be regarded as a rigid process. Instead, it should be regarded as a flexible process that provides patient with the right amount of information required to facilitate meaningful decision-making. Informed consent is an important ethical and practical part of patient care. Understanding the moral foundation of informed consent can help to guide therapists in their communication with all patients. Nurses, as members of the multidisciplinary team, are currently key contributors in providing information to patients regarding the treatment process. But in this process, there are some challenges that make it difficult. This paper describes the underlying ethical and regulatory requirements as well as related challenges regarding informed consent in the context of a nursing practice in Iran.

Keyword

Informed consent; Ethical challenge; Moral challenge; Nursing ethic; Iran

MeSH Terms

Ethics, Nursing
Humans
Informed Consent*
Iran
Nursing*
Patient Care

Reference

1. International Council of Nurses. The ICN code of ethics for nurses [Internet]. 2012. cited May 25, 2013.

2. Bollschweiler E, Apitzsch J, Obliers R, Koerfer A, Monig S, Metzger R. Improving informed consent of surgical patients using a multimedia-based program? Results of a prospective randomized multicenter study of patients before cholecystectomy. Ann Surg. 2008; 248(2):205–211. DOI: 10.1097/SLA.0b013e318180a3a7.

3. Akkad A, Jackson C, Kenyon S, Dixon-Woods M, Taub N, Habiba M. Informed consent for elective and emergency surgery: questionnaire study. BJOG. 2004; 111(10):1133–1138. DOI: 10.1111/j.1471-0528.2005.00669.x.

4. McNutt LA, Waltermaurer E, Bednarczyk RA, Carlson BE, Kotval J, McCauley J, et al. Are we misjudging how well informed consent forms are read. J Empir Res Hum Res Ethics. 2008; 3(1):89–97. DOI: 10.1525/jer.2008.3.1.89.

5. Bal BS, Lawrence H, Brenner JD. Medicolegal sidebar: Informed consent in the information age. Clin Orthop Relat Res. 2015; 473(9):2757–2761. DOI: 10.1007/s11999-015-4440-5.

6. Shekelle PG, Wachter RM, Pronovost PJ, Schoelles K, McDonald KM, Dy SM, et al. Making health care safer II: an updated critical analysis of the evidence for patient safety practices. Evid Rep Technol Assess (Full Rep). 2013; (211):1–945.

7. Shojania KG, Duncan BW, McDonald KM, Wachter RM, Markowitz AJ. Making health care safer: a critical analysis of patient safety practices. Evidence Report/Technology Assessment. Number 43. Rockville, MD: Agency for Healthcare Research and Quality;2004.

8. Schenker Y, Meisel A. Informed consent in clinical care: practical considerations in the effort to achieve ethical goals. JAMA. 2011; 305:1130–1131. DOI: 10.1001/jama.2011.333.

9. Bernat J, Peterson L. Patient-centered informed consent in surgical practice. Arch Surg. 2006; 141(1):86–92. DOI: 10.1001/archsurg.141.1.86.

10. Tenenbaum EM. Revitalizing informed consent and protecting patient autonomy: An appeal to abandon objective causation. Oklahoma Law Rev. 2012; 64:697–758.

11. Chan SW, Tulloch E, Sarah E, Smith A, Norman JE. Montgomery and informed consent: Where are we now? BMJ. 2017; 357:j2224. DOI: 10.1136/bmj.j2224.

12. Koller SE, Moore RF, Goldberg MB, Zhang J, Yu D, Conklin CB, et al. An informed consent program enhances surgery resident education. J Surg Educ. 2017; DOI: 10.1016/j.jsurg.2017.02.002.

13. Hudak JL, McLeod DG, Brassell SA, Gant DA, Shaar S, Hudak RP, et al. The design and implementations of a multidisciplinary prostate cancer clinic. Urol Nurs. 2007; 27(6):491–498.

14. Adib Hajbaghery M, Salsali M. A model for empowerment of nursing in Iran. BMC Health Serv Res. 2005; 5:24. DOI: 10.1186/1472-6963-5-24.

15. Gonzalez L. Nursing and the media: A mission for the center for nursing advocacy. Nev Rnformation. 2005; 14(4):21.

16. Koonrungsesomboon N, Teekachunhatean S, Hanprasertpong N, Laothavorn J, Na-Bangchang K, Karbwang J. Improved participants' understanding in a healthy volunteer study using the SIDCER informed consent form: a randomized-controlled study. Eur J Clin Pharmacol. 2016; 72:413–421. DOI: 10.1007/s00228-015-2000-2.

17. Joolaee S, Faghanipou S, Hajibabaee F. The quality of obtaining surgical informed consent Case study in Iran. Nurs Ethics. 2017; 24(2):167–176. DOI: 10.1177/0969733015584398.

18. Stacey D, Bennett CL, Barry MJ, Col NF, Eden KB, Holmes-Rovner M, et al. Decision aids for people facing health treatment or screening decisions. Cochrane Database Syst Rev. 2011; (10):CD001431. DOI: 10.1002/14651858.CD001431.pub3.

19. Ripley BA, Tiffany D, Lehmann LS, Silverman SG. Improving the informed consent conversation: A standardized checklist that is patient centered, quality driven, and legally sound. J Vasc Interv Radiol. 2015; 26(11):1639–1646. DOI: 10.1016/j.jvir.2015.06.007.

20. Frank RK. Shared decision-making and its role in end of life care. Br J Nurs. 2009; 18(10):612–618.

21. Barry M, Edgman-Levitan S. Shared decision making-pinnacle of patient-centered care. N Engl J Med. 2012; 366:780–781.

22. Shahriari M, Mohammadi E, Fooladi MM, Abbaszadeh A, Bahrami M. Proposing codes of ethics for Iranian nurses a mixed methods study. J Mix Methods Res. 2016; 10(4):52–366. DOI: 10.1177/1558689815570375.

23. Blease CR, Lilienfeld SO, Kelley JM. Evidence-Based Practice and Psychological Treatments: The Imperatives of Informed Consent. Front Psychol. 2016; 7:1170. DOI: 10.3389/fpsyg.2016.01170.

24. Pelto-Piri V, Engström K, Engström I. Paternalism, autonomy and reciprocity: Ethical perspectives in encounters with patients in psychiatric in-patient care. BMC Med Ethics. 2013; 4:49. DOI: 10.1186/1472-6939-14-49.

25. Rodriguez-Osorio CA, Dominguez-Cherit G. Medical decision making: Paternalism versus patient-centered autonomous care. Curr Opin Crit Care. 2008; 14(6):708–713. DOI: 10.1097/MCC.0b013e328315a611.

26. Olufowote JO. A dialectical perspective on informed consent to treatment: An examination of radiologists' dilemmas and negotiations. Qual Health Res. 2011; 21(6):839–852. DOI: 10.1177/1049732311402097.

27. Marvel MK, Epstein RM, Flowers K, Beckman HB. Soliciting the patient's agenda: Have we improved? JAMA. 1999; 281(3):283–287. DOI: 10.1001/jama.281.3.283.

28. Ford S, Schofield T, Hope T. Are patients' decision-making preferences being met? Health Expect. 2003; 6:72–80. DOI: 10.1046/j.1369-6513.2003.00211.x.

29. Bowers N, Eisenberg E, Montbriand J, Jaskolka J, Roche-Nagle G. Using a multimedia presentation to improve patient understanding and satisfaction with informed consent for minimally invasive vascular procedures. Surgeon. 2015; 15(1):7–11. DOI: 10.1016/j.surge.2015.09.001.

30. Halkoaho A, Pietilä AM, Ebbesen M. Cultural aspects related to informed consent in health research A systematic review. Nurs Ethics. 2016; 23(6):698–712. DOI: 10.1177/0969733015579312.

31. Murgic L, Hébert PC, Sovic S, Pavlekovic G. Paternalism and autonomy: Views of patients and providers in a transitional (post-communist) country. BMC Med Ethics. 2015; 16:65. DOI: 10.1186/s12910-015-0059-z.

32. Marrone SR. Informed consent examined within the context of culturally congruent care: An interprofessional perspective. J Transcult Nurs. 2016; 27(4):342–348. DOI: 10.1177/1043659615569537.