In this essay, I discuss the merits of contestability in contrast with consent as a meansof legitimizing the state. Particularly I have been concerned with problematiccontracts: Contracts with undefined obligations and their implications on thelegitimacy of voluntarist consent. Through my argumentation, I have shown thatvoluntarist consent to political mandates has a hard time legitimizing politicalauthority in the presence of problematic contracts – and instead, that legitimationbased on the the ability to contest decisions may provide a better degree of politicallegitimacy. Contestability can seemingly also be combined with elements of voluntaristconsent to further cement the legitimacy of decisions.

Practice and law around informed consent in healthcare have undergone a revolution for the better over recent decades. However the way we obtain informed consent remains problematic and is imbued with irreducible but not ineliminable uncertainty. The reasons for this uncertainty are varied. The uncertainty is partly due to the conceptual opacity of important core concepts. The complexity of communication in clinical encounters is another. The role of autonomy, and the changing nature of the clinician patient relationship, have also contributed to this uncertainty remaining. This thesis is not a panacea for these difficulties. However there have been two quite profound revolutions in healthcare over the last decade or so, namely, the introduction of evidence-based medicine into clinical decision making, and the institutionalization of clinical governance and the application of quality improvement philosophy. I have examined ways in which these two “movements” can help in reducing some of the uncertainty in the practice of informed consent.

Thesis (J.C.L.)--Catholic University of America, 2005. / Includes bibliographical references (leaves 66-71).

The aim of this thesis is to investigate the relationship between individuals and society in the context of healthcare and medical research, more specifically concerning the rights and duties of individuals in regard to biobank-based research. My starting point is that we all have a strong vested interest in improved healthcare, and therefore the possibilities to conduct important research should be optimized. In the first article, I investigate whether individual results from research using samples in large-scale biobanks should be returned. I conclude that there is good reason not to implement such policies, and instead to allocate available resources to pursuing medical advances. In the second article, I compare consent for using stored samples in research with consent for organ donation, whereby many countries have adopted opt-out strategies in order to increase the number of organs available. I claim that the default position should be changed in biobank research as well, i.e. it should be presumed that individuals want to contribute rather than that they do not. In the third article, I argue that safeguarding autonomy by requiring informed consent for using samples in research not only defeats the interests of society but also runs counter to the interests of the individuals the policy purports to protect. Finally, in the fourth article I suggest that it is reasonable to view participation in medical research from the perspective of a social contract, built on our mutual need for medical advances, and that this implies that there is a moral duty to adhere to the contract by allowing one’s samples to be used in research. A central conclusion in this thesis is that biobank research should be viewed as a natural part of healthcare, like quality control, method development and teaching, and that as such, it ought to be endorsed and facilitated.

A 2001 national study of college women’s sexual attitudes and behaviors revealed that students have stopped dating and started “hooking up.” Previous studies focused on fraternities and their relation to the rape culture but neglected to connect rape culture to hook up culture. This study evaluated the culture surrounding rape by interviewing seventeen college aged men about masculinity, behavior in male homosocial groups, “hooking up” and rape. It addresses the following questions: 1-How do college men understand “hooking up” and sexual consent? 2-In what ways might men’s understanding of “hooking up” and sexual consent be related to the ongoing incidence of rape on college campuses? 3- How do men understand and adhere to rape myths? In-depth interviews with college men in this study point to their dependence on nonverbal communication when negotiating “hookups,” with implications for their understandings of consent and perpetuation of myths concerning women's sexuality.

The Western liberal approach to informed consent defines autonomy as an independent choice or decision made by an individual as the final authority in medical decision-making. This approach is so dominant that one can fail to see the merits of other traditional and cultural perspectives. In this dissertation, another approach to informed consent is considered -that of communal culture of Africa, a process used in African traditional medicine (ATM) wherein patients make medical decisions and give consent in consultation with the members of their community and the ATM doctor. Often, but not necessarily, the final consent rests on the consensus reached in consultation with the group rather than on that by the individual patient alone. <br>This dissertation argues that the ATM form of consent constitutes legitimate informed consent based on the concept of relational autonomy, commonly called relational autonomy in informed consent (RAIC) in this dissertation. To interpret and enlighten the significance of the ATM approach to RAIC, the analysis in this dissertation examines the ethics of care movement in Western bioethics which also advocates a relational approach to informed consent. This movement presents a concept of persons as relational beings who are socially embedded, thereby interpreting patient autonomy in their relationships with others. This movement provides the hermeneutic to enlighten the significance of the ATM approach as a legitimate model of RAIC. <br>By comparison of the ethics of care approach with that of ATM to RAIC, this dissertation further provides a relational approach to informed consent in order to inform the restrictive emphasis on individual autonomy practiced in Western bioethics, all with a view towards fostering current discourse on global bioethics. The dissertation also provides an applied example of the contribution of ATM's RAIC approach to ethics committees in Africa, focusing in particular, on the decision-making process for patient informed consent. <br>This dissertation is distinct insofar as it focuses on informed consent in ATM, employs ethics of care as a hermeneutic to interpret ATM, advocates integrated model of healthcare ethics committees in ATM. Because ATM forms a large portion of the healthcare systems in Africa, it follows that ATM and its practices should receive more attention in bioethics in the present global era. / McAnulty College and Graduate School of Liberal Arts; / Health Care Ethics / PhD; / Dissertation;

Syftet med studien är att undersöka hur en population av potentiellt blivande föräldrar i åldrarna 20-40 år önskar att handläggning av informationen kring ultraljudsmarkörer bör se ut. Studien utformades som en pilotstudie med bekvämlighetsurval, och en enkät med parametrar fördelade på 11 scenarion utarbetades. Enkäten delades ut på föreläsningar i och omkring Stockholm i april 2012. 49 kvinnor och 36 män deltog i undersökningen. Potentiellt blivande föräldrar vill ofta få information om upptäckta softmarkers. Dock svarar en betydande del av försökspersonerna att de för vissa scenarion inte vill ta del av all tillgänglig information. Flest vill ha information vid obotliga tillstånd och när markören sitter i fostrets hjärna eller hjärta. De scenarion där flest svarar att de inte vill bli informerade är då markören sitter i fostrets tarm eller skelett samt när tillståndet är bortbart. Signifikanta skillnader uppmättes mellan olika gruppers svar. Kvinnor svarar oftare än män att de inte vill ha information om funna softmarkers. Detsamma gäller för sambos/gifta när man jämför dem med de som är singlar. De som hade barn vill oftare inte veta om att en softmarker har upptäckts jämfört med de som inte har barn. / The aim of the study was to investigate how potential new parents aged 20-40 would prefer the information about soft markers to be handled. The study was designed as a pilot study, and a questionnaire was made with parameters divided into 11 scenarios. The questionnaire was handed out at lectures in the Stockholm area in April of 2012. Answers were analyzed in SPSS with chi-2 tests. 49 women and 36 men participated in the study. Potential new parents often wish to be informed of discovered soft markers. However, a significant portion of the participants say they prefer not to know about soft markers in their foetus in some scenarios. Scenarios where the condition is incurable or where the soft marker is placed in the brain or heart of the foetus are the ones where the most people say they want the information. A soft marker placed in the foetus’ intestines or skeleton is when the most people answer that they do not wish to recieve this information. Significant differences are seen between different groups. Women more often than men say they do not want information about a discovered soft marker. The same is true for those who are married or cohabitating when compared to singles. Those who are already parents want information about a soft marker to a lower degree than those who do not have children.

<p>This thesis deals with political representation in EU multi-level governance. The European Union and its political system is quite complex, due to its unusual and multi-level governance.</p><p>It has gained the reputation of capturing professionalism, and conforming to elite governance to a point where it is seen as an elite political game.</p><p>The thesis wish to examine the European political system, and ask the questions, how important is the degree of consent between the political elite and the public in the European Union? Does it necessarily have an effect on the system of political representation as such, and if is does, does it influence legitimacy? Or in other terms, is it necessary for a degree of consent between the political elite and the public for political representation and legitimacy?</p><p>The European Union has a tendancy to gain critique for its focus on professionalism and elitism, and I wish therefore to state that it is important to generate an evident relationship between political representation and legitimacy in EU multi-level governance. It is necessesary to create a functioning relationship between the political elite and the public, but it does not necessarily mean that it influence political representation and legitimacy. It is important to view the opportunities for political representation and legitimacy in a situation such as this. The degree of consent is not to create an impossibility for sufficient political representation and legitimacy in the European Union, is it?</p>

Thesis (doctoral)--Konstanz Universität, Konstanz, 2009. / Includes bibliographical references (p. [354]-367) and index.

Thesis (J.C.L.)--Catholic University of America, 2008. / Description based on Microfiche version record. Includes bibliographical references (leaves 48-52).