Cultural Contexts Impacting Patient Informed Consent

Patient autonomy is critical for appropriate discharge of ethically-sound healthcare. To uphold patient autonomy, many healthcare providers follow a standardized process wherein patients are presented with information relevant to their medical condition, followed by potential treatment modalities including the risks and benefits of each. This concludes with an opportunity for patients to ask questions or seek clarifications and should all information be satisfactory, a patient or representative will then sign a document as written proof of consent and of maintained autonomy. This process, while standard and vital to patient care, is not translatable in all countries or across all cultures. Many cultures value community-dependent decision-making, and offer communal consent as the first step when addressing global collaborations, particularly for research. Barriers that have been identified in the lack of translatability stem from different core values and extend into many more aspects of education and fund of knowledge access. The purpose of this presentation is to utilize an anecdotal case to focus on these barriers, characterize them and highlight their roots – are they truly simply a lack of access or are there misconceptions about not only the definition of consent, but also the consent process in these cultures? Characterizing the relationship between communal consent and the current Westernized definition of informed consent will be helpful as we as a global community move to expanding international collaborations and improving global access to healthcare. On the basis of this relationship, an international standard can be established for obtaining patient consent and ensuring the integrity of patient autonomy.

Leslie Ann McNolty, DPS MA – Bioethics, University of Missouri - Kansas City School of Medicine; Kennedy Jensen, MD – Geisel School of Medicine at Dartmouth Hanover, NH and University of Utah School of Medicine, Salt Lake City, UT; Ashish Bosco, MD - St. Johns Medical College and Hospital, Bangalore, Karnataka, India; Geoffrey A. Anderson, MD MPH – Surgery, Brigham and Women's Hospital, Boston, MA and US Air Force Reserves, 439th Aeromedical Staging Squadron, Westover Air Reserve Base, MA, USA; Craig McClain, MD, – Associate Professor of Anaesthesia, Department of Anesthesia, Boston Children's Hospital