Section 1.47 min read

Informed Consent

Core summary

Informed consent is a process, not just a signature. It requires providing clear information about the study, ensuring comprehension, and obtaining voluntary agreement. Required elements include purpose, procedures, risks, benefits, alternatives, confidentiality, and the right to withdraw. Special situations may allow consent waivers.

Detailed explanation

The consent process has three components: information (disclosure of relevant details), comprehension (participant understands what is being asked), and voluntariness (no coercion or undue influence). Required elements include: a statement that the study involves research, explanation of purpose and procedures, description of foreseeable risks and discomforts, description of expected benefits, disclosure of alternatives, explanation of confidentiality measures, compensation and treatment for injury (if applicable), contact information for questions, and a statement that participation is voluntary with the right to withdraw at any time without penalty. Assent is used for children (typically ages 7-17) who cannot legally consent but can express willingness to participate; their parent/guardian provides consent while the child provides assent. Consent waivers may be approved by the IRB when: the research poses no more than minimal risk, the waiver will not adversely affect participants' rights, the research could not practicably be carried out without the waiver, and participants will be provided additional pertinent information afterward when appropriate. Common waiver situations include large-scale retrospective data studies and emergency research.

Clinical example

You recruit patients from the emergency department for a study on acute pain management. The consent form is written in simple language, uses bullet points for risks, and includes a phone number patients can call later with questions. You ensure the consent conversation happens in a private area, not at the busy bedside, and give patients time to decide without pressure.

Research example

The EXCEPTION trial (2005-2009) studied emergency treatments for cardiac arrest where patients could not consent. The FDA approved a waiver of informed consent for emergency research, requiring community consultation and public notification instead. This exception allows life-saving research that would otherwise be impossible.

Knowledge check

Q1. What are the three components of the informed consent process?

Q2. What is 'assent' in research?

Q3. Under what condition might an IRB waive informed consent?