Proefschrift Rijksuniversiteit Limburg, Maastricht. / Met lit. opg. - Met samenvatting in het Nederlands.

Purpose To assess patient satisfaction with the use of Portable Video Media (PVM) for the purpose of taking informed consent for common urological outpatient procedures performed under local anaesthesia. Methods Patients undergoing the following procedures were approached for recruitment: flexible cystoscopy with or without biopsy, transrectal ultrasound-guided prostate biopsy or flexible cystoscopy with insertion or removal of a ureteric stent. Audio-visual media were developed for each procedure, with each script translated from English into isiXhosa and Afrikaans. The study involved a cross-over for each patient between Standard Verbal Consent (SVC) and PVM consent, with each patient randomised to start with SVC or PVM consent. Each of these consent-arms were assessed via a questionnaire. Results 60 patients completed participation, with PVM as the first exposure for 28 patients and 32 patients receiving SVC as their first arm of the study. When comparing the overall satisfaction between SVC and PVM consent (the total scores out of 18 for the questionnaire), patients scored significantly higher for PVM consent (M = 16.3 ± 2.4) compared to SVC (M = 15.4 ± 2.9) (p = 0.002). 92% of the total patient sample preferred PVM consent. Conclusion PVM proved superior to SVC in improving satisfaction in the consent process for common outpatient urological procedures performed under local anaesthesia.

This thesis argues that stem cells cannot be properly regulated when understood in terms of medical treatment only. This is due to the uncertain scope and untested efficacy of stem cell therapy which renders treatment applications tantamount to research involving human subjects. This thesis therefore examines consent as regulatory instrument in context of stem cell related interventions and endeavours to introduce a sufficient consent model for such interventions. To this end, a clinical overview and explanation of stem cells is provided in order to establish an understanding of the field of science in need of regulatory control. This is followed by a background and introduction to consent, a discussion of specific aspects of consent and the National Health Act of 2003 and the Regulations made in terms of the Act to provide insight into consent as understood in South Africa. Consent in international instruments and international law is then examined. The law of the United Kingdom is also analysed by providing an examination of the legal systems in the United Kingdom which is then followed by a discussion of the Human Tissue Act of 2004 and the Human Tissue (Scotland) Act of 2006. Finally, dynamic informed consent is explained and introduced as the recommended consent format for the proper and valid regulation of stem cell therapy-research interventions. At the close of this thesis, the conclusions drawn throughout are compounded and pertinent recommendations are made regarding consent procedures and specifications. / Thesis (LLD)--University of Pretoria, 2016. / Public Law / LLD / Unrestricted

Thesis advisor: Susan M. Shell / In On the right to punish and grant clemency, Immanuel Kant attempts to resolve a potential paradox in social contract theory. The government is the political authority tasked with execution of the rule of law. On the one hand, the execution of the rule of law is consensual and meant to serve the individual citizen. On the other hand, the execution of the rule of law requires punishment (a nonconsensual action). A consensual condition requires a nonconsensual component. This thesis analyzes Kant’s attempt to resolve this issue through his use of a retributivist framework of punishment. / Thesis (MA) — Boston College, 2022. / Submitted to: Boston College. Graduate School of Arts and Sciences. / Discipline: Political Science.

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Ziele: Das Ziel der vorliegenden Arbeit ist eine standardisierte Analyse der Patientenzufriedenheit mit dem Aufklärungsgespräch und die mögliche Einflussfaktoren, die hier eine Rolle spielen können, zu bieten. Methodik: Es wurden 189 Fragebögen bzw. Aufklärungsgespräche in den Kliniken für Anästhesie und Innere Medizin im St. Josef Krankenhaus und Chirurgie und Kinder- und Jugendpsychiatrie im Leopoldina Krankenhaus in Schweinfurt untersucht. Ergebnisse: Der Fragebogen, der verwendet wurde, war reliabel. Es zeigte sich eine schlechte Item-Selektivität. Die Kriteriumsvalidität konnte bestätigt werden jedoch nicht die diskriminante Validität. Die Patienten waren zufriedener mit Ärzten, die Deutsch als Muttersprache angaben, mit längeren Aufklärungsgesprächen und mit Fachärzten im Vergleich zu Assistenzärzten. Eine höhere allgemeine Lebenszufriedenheit war mit höherer Patientenzufriedenheit mit dem Aufklärungsgespräch assoziiert. Der moralistische Bias kann einen Störfaktor der Validität der Messungen darstellen. Zusammenfassung: Eine angemessene Gesprächdauer, die deutsche Muttersprache und der Facharztstatus des aufklärenden Arztes haben einen positiven Einfluss auf die Patientenzufriedenheit mit dem Aufklärungsgespräch. Um sicher zu stellen, welche von diesen drei Faktoren besondere Wichtigkeit besitzt, werden weitere Untersuchungen benötigt. / Objective: The aim of the present study is to provide a standardized analysis of patient satisfaction with informed consent process and the possible influencing factors that can play a role here. Methoden: 189 questionnaires/informed consent were examined in the clinics for anesthesia and internal medicine in St. Josef Hospital and surgery and child and adolescent psychiatry in Leopoldina Hospital in Schweinfurt. Results: The questionnaire used was reliable. There was poor item selectivity. The criterion validity was confirmed but not the discriminant validity. Patients were more satisfied with doctors who spoke German as their native language, with longer duration oft the informed consent process and with specialists compared to assistant doctors. Higher general life satisfaction was associated with higher patient satisfaction. The moralistic bias can represent a confounding factor in the validity of the measurements. Conclusion: An appropriate duration of the conversation, the German native language and the doctor's specialist status have a positive influence on patient satisfaction with informed consent process. Further research is needed to determine which of these three factors is particularly important.

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