The study took as its point of departure the Children’s Act No 38 of 2005 that emanated from the Bill of Rights enshrined in the Constitution of the Republic of South Africa (Act 108 of 1996). This Act has as its primary aims, to promote the preservation and strengthening of families and to give effect to the rights of children as enshrined in the Constitution of the Republic of South Africa, including: protection of children from maltreatment, neglect, abuse or degradation and the fact that the best interest of a child are of paramount importance in every matter concerning children. It was anticipated that the areas of the Children’s Act with its emphasis on the rights of children would empower them in relation to their protection and development in that particular context. When the Act was introduced, it evoked mixed reactions with certain segments of society applauding the government for its efforts, and others condemning the government’s approach towards reproductive health issues affecting children. The primary aim of the research project was to explore the views of a group of parents in the Johannesburg Metro Region 11 regarding reproductive health care as embedded in the Children’s Act. The study took the form of a small-scale, mixed methods, descriptive, cross-sectional survey research design as it sought to elicit participants’ views on those specific clauses in the Act. In addressing the aims and objectives of the study, interview schedules were administered to 35 participants on an individual, face-to-face basis. Participants were adults drawn from Johannesburg Metro Region 11 and the data collected was analysed using descriptive statistics and thematic content analysis. The main findings that emerged from the study were that, participants did not participate in the process leading up to the promulgation of the Children’s Act No 38 of 2005. Consequently, participants had little knowledge about the Act and did not have any knowledge about its objectives. The fact that participants did not support certain clauses has implications for amendment of the Act with reference to the clauses on reproductive health care.

Thesis advisor: Christopher J. Kelly / This dissertation is an attempt to elucidate Jean-Jacques Rousseau's answer to the question "why keep a promise?" with the aim of answering the more particular political question of why one should keep the social contract. I begin by explicating Rousseau's arguments against natural law in order to demonstrate why the theme of promises is so important for his political thought. Rousseau rejects the position that natural moral inequalities among people dictate who should rule and who should be ruled. Like other modern political thinkers, he maintains that political right derives from each citizen's signing of the social contract. But unlike some other modern thinkers, Rousseau denies that the self-interest of each individual is sufficient motivation for keeping that contract. Moreover, he argues that one who is merely self-interested and who makes promises "only for profit" will "set himself in contradiction with himself." I show the nature and causes of this contradiction in the soul. But although self-interested, deceitful promises cause one to come into contradiction with oneself, Rousseau does not believe that even awareness of this fact can sufficiently motivate people to give up the desire for what can be gained by deception. I therefore turn to the question of what can provide this motivation. I first examine Rousseau's understanding of moral freedom, virtue, and the conscience. I find that virtue is constituted by the commands of reason and the conscience, and that the conscience is formed out of well-ordered sentiments. Having these sentiments and the strength of soul necessary for virtue can make a person keep his promises and avoid coming into contradiction with himself. But most people lack this strength of soul, and therefore belief in a providential God is needed in order for them to be just. I then show how the faith of Rousseau's Savoyard Vicar is capable of providing sanctity to the social contract by allowing for the civic-minded appropriation of what Rousseau calls "the language of sign." / Thesis (PhD) — Boston College, 2014. / Submitted to: Boston College. Graduate School of Arts and Sciences. / Discipline: Political Science.

In modern international law, it is a near consensus that no state can use force against another - the main exceptions being self-defense and actions mandated by a U.N. Security Council resolution. However, one more potential exception exists: forcible intervention undertaken upon the invitation or consent of a government, seeking assistance in confronting armed opposition groups within its territory. This dissertation seeks to analyze the consent-exception in a wide context, and attempting to delineate its limits - including, perhaps, cases in which government consent power is not only negated, but might be transferred to opposition groups.

Orientadores: Ellen E. Hardy, Maria Jose Duarte Osis / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-11-09T15:33:56Z (GMT). No. of bitstreams: 1 Bento_SilvanaBento_M.pdf: 941638 bytes, checksum: db46ec0ea7c28aec47376a653ccf046c (MD5) Previous issue date: 2006 / Resumo: Os documentos nacionais e internacionais que estabelecem as normas que regulamentam as pesquisas em seres humanos, fazem menção ao consentimento informado. O consentimento de um possível voluntário para participar de uma pesquisa deve ser obtido através de um processo que permita à pessoa compreender as informações dadas. Esse processo envolve respeito mútuo, diálogo, paciência e persistência. Começa no primeiro contato do pesquisador com o possível participante e continua durante todo o estudo. No Brasil, a Resolução 196/96 determina que toda pesquisa que envolva seres humanos deve ter um Termo de Consentimento Livre e Esclarecido (TCLE) a ser assinado pelos sujeitos. Objetivo: Identificar as informações que as mulheres ¿ possíveis voluntárias - gostariam de receber antes de aceitar participar ou não de uma pesquisa, bem como o que pensam com relação ao processo a ser seguido para obter seu consentimento. Conhecer a opinião de mulheres voluntárias de um ensaio clínico sobre que informações gostariam de receber e sobre como deveria ser o processo de obtenção do consentimento informado. Sujeitos e Método: estudo qualitativo, utilizando a técnica de grupos focais. Realizaram-se oito grupos com mulheres, moradoras da Região Metropolitana de Campinas e que estavam participando ou haviam participado de um ensaio clínico na área de saúde da mulher nos doze meses anteriores ao estudo. Ao todo participaram 51 mulheres, alocadas em grupos distintos conforme a idade e a escolaridade. O roteiro para as discussões abordava questões sobre quais informações mulheres convidadas a participar de uma pesquisa sobre um método contraceptivo gostariam de receber, e como achavam que essas informações deveriam ser dadas. As discussões nos grupos foram gravadas e transcritas para realizar a análise temática de seu conteúdo. As categorias de análise estudadas foram: profissional que deveria fornecer as informações sobre a pesquisa, atitude do profissional, quantidade de informação, forma de passar a informação, informações que gostariam de receber, recursos didáticos que poderiam ser utilizados. O projeto de pesquisa foi aprovado pelo Comitê de Ética em Pesquisa da Faculdade de Ciências Médicas da Unicamp. Resultados: Na opinião das participantes, em geral, quem deve convidar uma mulher para participar é um membro da equipe de pesquisa e não o pesquisador responsável, por estar ocupado e distante da realidade delas. As informações deveriam ser dadas oralmente e por escrito, individualmente e em grupo. As participantes entendiam que não existe uma quantidade de informações específica a ser dada aos possíveis sujeitos de pesquisa. Enfatizaram que o mais importante não é a quantidade de informações, mas a maneira como são dadas, de forma clara e objetiva para que as mulheres as entendam. Segundo elas, para poder tomar uma decisão consciente, as possíveis voluntárias de uma pesquisa devem ser informadas, entre outros aspectos, sobre os riscos, possíveis efeitos colaterais e desconfortos, inclusive a longo prazo. Sugeriram o uso de recursos audiovisuais: vídeos, cartilhas e folhetos. Conclusão: As informações que as mulheres, possíveis voluntárias, gostariam de receber são, em geral, as mesmas estabelecidas pela Resolução 196/96. Elas não consideraram o processo de obtenção do consentimento como um mero ritual, mas como um meio de estabelecer um vínculo entre as possíveis voluntárias e o pesquisador/ equipe de pesquisa. Além disso, consideraram que os recursos audiovisuais facilitariam a compreensão das informações / Abstract: The national and intemational documents that establish the norms regulating research with human subjects refer to informed consent. The agreement of a potential volunteer to participate in research should be obtained by means of a process that ensures that the person understands the information given. This process involves mutual respect, dialogue, patience and persistence. It begins with the first contact of the investigator with the potential participant and continues throughout the study. In Brazil, the Resolution 196/96 determines that ali research involving human subjects should have an Informed Consent form to be signed by the subjects. Objective: To evaluate the opinion of women regarding the information they would like to receive before accepting or refusing to participate in a study, as well as how the process to obtain informed consent should be conducted. Subjects and Methods: This was a qualitative study carried out with the focus group technique. Eight focus groups were carried out with women who lived in the Metropolitan Region of Campinas (São Paulo state, Brazil) and who were participating or had participated in a clinical trial in the field of women's health during the twelve-month period preceding the investigation. Fifty one women participated, divided into distinct groups according to age and schooling. The discussion guide included questions on what information women invited to participate in a study on a contraceptive method would like to receive, and how they believed this information should be provided. Group discussions were tape recorded and transcribed for subsequent thematic analysis. The categories of analysis studied were: professional who should supply the information on the study; attitude of that professional; amount of information to be provided; manner in which the information should be given; information they would like to receive; teaching aids that could be used. The research project was approved by the IRB of the School of Medical Sciences of the Universidade Estadual de Campinas (Unicamp). Results: According to the participants, in general the person who invites a woman to participate should be a member of the research team - and not the principal investigator, who is busy and distant from the women's reality. The information should be given orally and in writing, individually and in a group. The participants believed that there is no specific amount of information to be given to potential study subjects. They emphasized that the amount of information was not the most important but, rather, the process followed to provide it, clearly and objectively so that the women understand. consent as a mere ritual, but as a means to establish a bond between the potential volunteers and the investigator/research team. Furthermore, they believed that audiovisual . aids would facilitate the understanding of the information provided. / Mestrado / Ciencias Biomedicas / Mestre em Tocoginecologia

MMed, Family Medicine, University of the Witwatersrand, 2011 / Background Informed consent is required for any surgical procedure. It is a demonstration of a patient‟s agreement to have surgery performed. Many studies have considered the quality of informed consent in clinical trials. However, only few studies have assessed patients‟ understanding of the process of informed consent in clinical practice. This descriptive cross-sectional study has looked at patients‟ perceptions and understanding of informed consent process for surgical procedures. Aim To explore patients‟ perceptions on informed consent and ascertain if those who have signed for surgical procedures have adequate understanding of the informed consent process. Objectives 1. To ascertain patients‟ perceptions of the process of informed consent; 2. To determine patients‟ recollection of elements of this process that were considered when they signed the consent. 5 3. To explore if patients understand the meaning and implications of the informed consent process; 4. To determine whether patients obtained information about procedures from sources other than the healthcare workers; Methods This was a descriptive cross-sectional study conducted among patients admitted at Leratong hospital for elective surgery. A sample of patients (n=98) selected from those booked for elective surgery at Leratong theatres between April 2008 and June 2008 were interviewed. Different aspects of information were analysed. Specifically: social and demographic profile, formal education, previous medical and surgical history, perceptions of informed consent, process of informed consent and knowledge of the procedure‟s indication, risks and alternatives. Equally considered were sources and value of external medical information. Results Patients interviewed represented 5.5% of the total of those booked for elective surgery. The median similar to the modal age was 38 years, 58.2% being females. Only 4.1% had tertiary education, 32% did not reach secondary school of which 11.2% had no formal education at all. Concerning their prior medical /surgical background, 26.5% were on chronic medical treatment and 48% had previous surgery. More than two third (91%) of them had stayed in the hospital for more than 12 hours prior to surgery. 6 Only 27% perceived the signing of consent form as a proof that they understood the procedure. It was demonstrated that the higher the education level the better the perceptions of informed consent process (P=0.0006). More than 2/3 of patients needed further explanation in their mother tongue to understand the information. Seventy-four per cent did not read the consent form. The understanding of information was more likely to be checked when the information was given by a doctor than by a nursing sister (P=0.014). Only 8% admitted to know some alternatives to the proposed procedure, 13% of patients knew the risks. Formal education was not linked to better understanding of the informed consent process (P=0.245). Patients claiming to have received further information on the procedure from sources other than the healthcare system did not show an added advantage on understanding (P=0.152). The study has demonstrated the low level of understanding of informed consent process in this provincial public hospital. It has shown the public perceptions of the consent form, and the advantage granted by the formal education in this regards. Based on these results, it is therefore recommended that an approved translation of the consent form be made available to patients as an alternative to those who are not English speakers. A proper guideline should be established for physicians to ensure disclosure of information in language of choice of patients to obtain better informed consent.

Tissue banks are thought to be an essential resource for medical research in the post-genomic age. Collections of tissue, usually removed in the course of diagnostic or therapeutic procedures, enable laboratory-based epidemiological studies to be carried out, linking abnormalities in the tissue to disease aetiology, prognosis and treatment responsiveness. There are, however, a number of technical, regulatory and ethical concerns that challenge those wishing to engage in tissue banking research. It is becoming increasingly apparent that tissue banking research is not without risk of harms, even though there is no direct physical risk to donors. This is because, in order to be most useful, banked specimens need to be linked to personal information about tissue donors and this poses the risk of inadvertent disclosure of personal─ particularly genetic─ information to those who might exploit such information (eg. insurance companies and employers). Furthermore, the long-term storage of specimens, and the impossibility of predicting all potential types of research programs for which they might be useful, raises the possibility that future projects will be carried out that are unacceptable to some (past) tissue donors. The ethical principles of autonomy and respect for persons demand that research subjects be informed of such risks and of the nature of the research, and that they participate willingly. On the other hand, there is a desire for science to progress unhindered by stringent consent requirements. For these reasons, a debate has emerged in the academic (bioethical and biomedical) literature and in the legal (law reform) sphere over what would constitute adequate consent. Despite an extensive discourse, it is still unclear whether it is permissible to carry out research on archival tissue that was originally taken for diagnostic purposes and whether project-specific (as opposed to open-ended) consent is required for research on tissue collected today. This lack of clarity is of concern to researchers, ethics committees and research subjects, all of whom recognise the importance of tissue banking research, yet fear that current consent procedures may be ethically or legally inadequate. Thus it is important that the consent dilemma be resolved as quickly and definitively as possible. Ongoing controversy and regulatory ambiguity are appropriate when morally contentious issues are at stake, and their existence does not, on its own, signal any flaws in the discourse process. There are, however, two reasons to suspect that the current �consent to tissue banking� debate, as portrayed in the academic literature and law reform documentation, is problematic. Firstly, the debate appears to be mired in an intractable conflict between those who want to maximise personal autonomy through stringent consent requirements, and those who want the scientific endeavour to progress in a manner that is unconstrained by what are viewed as arduous consent procedures. Secondly, the possible practical options (consent models) being generated by the debate are all limited because they are underpinned by a restricted notion of consent as an individualistic, legalistic and static activity, without consideration of any alternative conceptualisations of consent. Through a thematic analysis of the current �consent to tissue banking� debate in the academic and law reform literature (Section 3), this thesis shows that debate is essentially occurring between those who see individual autonomy (and stringent consent) as being of primary importance, and those who see unimpeded, market-driven scientific progress as the more important social good, which should not be impeded by unnecessarily stringent consent. Thematic analysis also confirms the existence of the two problems described above, and a failure of those engaged in the debate to reflect on, and challenge, the value-level assumptions underpinning their arguments and those of their opponents. It is argued that this lack of reflection accounts for the two problems: � Firstly, it precludes recognition of the cause of─ and, therefore, ways of resolving─ the intractable conflict at the centre of the debate. Value-level reflection shows that this is a result of the logical and moral conflict within western liberalism, between two modernist goods: individual freedom and scientific progress. � Secondly, it precludes the generation of varied conceptions of consent. Value-level reflection shows that the current range of consent models is restricted to procedures which are individualistic, abstract, static and legalistic, since they are underpinned by western liberal notions of autonomy and scientific progress. This recognition paves the way to consideration of alternative notions of autonomy, scientific progress and, therefore, consent, such as those derived from communitarian and feminist systems of values. A conceptually enriched model of tissue banking consent is then developed (Section 4). This model incorporates dominant (liberal) conceptions of autonomy and scientific progress as well as alternative notions of autonomy and scientific progress espoused by communitarian and feminist systems of values. It is argued that this conceptually-enriched model provides a practical solution to the two problems associated with the standard �consent to tissue banking� debate. In relation to the philosophically intractable conflict─ or what is termed the �modernist dilemma�─ between those privileging autonomy and those privileging scientific progress, it shows how the two apparently conflicting �modernist� goods can both be accommodated at a practical level, thus making the �consent to tissue banking� debate more tractable and fruitful. In relation to the restricted range of consent models being generated by the current debate, it provides new insights into the ways in which consent might be obtained such that a broader range of community values can be accommodated. More specifically, it stimulates the construction of a model that 1) involves communities, as opposed to merely individuals, in all stages of the scientific process; 2) is flexible and able to adapt consent procedures to specific contexts, rather than predefining procedures in abstract terms; and 3) is transactional and relational rather than static and legalistic. This outcome has interesting philosophical as well as practical implications. It shows that despite apparently unresolved, and possibly irresolvable, normative-level conflicts between the two modernist elements of western liberalism (autonomy and scientific progress), and between liberal, feminist and communitarian systems of values, a multi-perspectival, inclusive, model-building approach provides a practical solution that circumvents these normative-level conflicts.

Background: Informed consent is the autonomy of the patient who involves decision-making after being informed of and understanding the physician. Objectives: This study sought to investigate and compare patients¡¦ and physicians¡¦ perceptions of informed consent and the factors that influence their viewpoints on informed consent. Methods: The subjects were citizens without medical background and physicians working in four hospitals. Self-structured questionnaire was used to gather information. The physicians were recruited from two medical centers, a regional hospital and a district hospital in Kaohsiung. The data is analyzed by SPSS 14.0 and used descriptive statistics, item analysis, factor analysis, chi-square test, Fisher's exact probability test, t-test, and ANOVA. Results: The response rates were 97% in citizens (n=891) and 79 % in physicians (n=158). As for the concept of informed consent, 55.7% citizens thought that doctor should respect the opinion from the patient and family during the informed consent process. Furthermore, 91.2% the citizens prefer to know the information about their health condition from the physicians rather than from family (8.8%). Regarding the sequence of informing the physical condition, 29.9% citizens also prefer directly from the physician. As for the decision-making process, 55% respondents thought that patient¡¦s own decision is the most important. 52.5% physicians thought that doctor should respect the opinion from both the patient and family and the bad news should be informed by physicians (88.0%) rather than by family. As for the sequence of knowing the bad news, 46.2% physicians preferred to inform family first and inform patient after discussing with family. In decision-making process, 48.7% physicians thought that physician¡¦s opinion was still more important than opinion of patients and family. Further analysis revealed that patients¡¦ gender and the level of family visited hospital have significant difference on the perception of informed consent (p=0.027; p=0.000); gender, age, educational background and living locations also have significant difference on ¡§who to deliver the bad news.¡¨ (p=0.006; p=0.004; p=0.035; p=0.012); Citizens¡¦ age, educational background and career have significant influence on their opinion of informed consent of recently visiting doctor (p=0.014; p=0.006; p=0.001). The variables in the physicians¡¦ background have no relation with the means of informing and decision-making. The gender and position of the physician have significant effect on the opinion of practice of informed consent (p=0.015 and p=0.001). Conclusions: We concluded that the perceptions of informed consent, there was no difference between physicians and citizens; however the citizen chose the patient first, and the physician chose the family first during the process of informed consent. Physicians have better perceptions of informed consent than the common citizens.

Zugl.: Diss.

Thesis (Ph. D.)--UCLA, 2009. / Vita. Description based on print version record. Includes bibliographical references (leaves 149-151).

Professionals whose job it is to counsel patients must be cognizant of the role played by communication in the establishment of a trusting working relationship. This is no less true for those within the medical community who must obtain informed consent for surgical interventions than it is for those working within the area of mental health. In order to determine what role communication plays in the obtaining of informed consent within a pediatrics setting, a qualitative study was conducted of 20 surrogates (those individuals giving consent on behalf of legally incompetent children) and of 5 surgeons performing surgical interventions on those children. Two sets of questionnaires were administered in order to elicit information pertaining to how surgeons communicate information to surrogates and to investigate how that information is received and processed by the surrogate. Results showed that while the obtaining of signed informed consent itself may not be a major problem, there are some difficulties in the communication between surgeons and surrogates in this domain. Based on the findings, recommendations for improved communication between surgeons and surrogates are proposed.