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Ethical guidelines for COVID-19 tracing apps – Nature (Jessica Morley, et al | May 2020)0

Posted by Admin in on June 13, 2020
 

Protect privacy, equality and fairness in digital contact tracing with these key questions.

Technologies to rapidly alert people when they have been in contact with someone carrying the coronavirus SARS-CoV-2 are part of a strategy to bring the pandemic under control. Currently, at least 47 contact-tracing apps are available globally (see go.nature.com/2zc1qhk). They are already in use in Australia, South Korea and Singapore, for instance. And many other governments are testing or considering them.

Not really research, but a topical discussion on big data, privacy, consent and respect for persons, which are of significance to research.

Here we set out 16 questions to assess whether — and to what extent — a contact-tracing app is ethically justifiable. These questions could assist governments, public-health agencies and providers to develop ethical apps — they have already informed developments in France, Italy and the United Kingdom. They will also help watchdogs and others to scrutinize such technologies.
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What do COVID-19 contact-tracing apps do? Running on a mobile phone, they inform people that they have spent time near someone with the virus. The contacts should then respond according to local rules, for example by isolating themselves. Prompt alerts are key because the incubation time of the virus is up to two weeks.

Read the rest of this discussion piece

Should We Purposely Infect Healthy Volunteers With Covid-19? – WIRED (Victoria Turk | May 2020)0

Posted by Admin in on June 4, 2020
 

Such studies could speed up the development of a vaccine—but would mean deliberately giving people a disease that could kill them.

IN LATE MARCH, Josh Morrison was sitting in his apartment in Brooklyn, New York, feeling miserable. Work had slowed down at the nonprofit he runs, which advocates for living organ donors, and he was worried about his parents and whether they were following the guidelines to stay safe during the coronavirus pandemic. He’d been planning to visit them in early April for their 40th anniversary in Florida, but had to cancel. “That was hard, and that was really sad,” he says. “I really want to be able to see my parents as soon as I can, and be back to a situation where you can do that.”

Ethical reflections when they are theoretical can be entertaining and engaging, but the stakes and consequences here are frightening and real.  In a world desperate for a cure, a vaccine or just an efficacious treatment, how far should we go?  Should we allow people to expose themselves to a risk of death or potentially longterm disability?

Morrison, who is 34, felt powerless. He wanted to be able to do something constructive. It was in this context that he came across a paper in The Journal of Infectious Diseases which put forward the case for human challenge studies of Covid-19 vaccine candidates. Challenge studies purposely infect healthy volunteers with a pathogen in order to study a disease or test a treatment or vaccine. This paper suggested that using human challenge studies could speed up the development of a Covid-19 vaccine by months, potentially saving thousands of lives. “The idea of speeding that all up and getting this stuff done with is pretty appealing,” Morrison says. “And also, I thought that I personally could participate in one of these.”
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After contacting some friends, Morrison set up 1 Day Sooner, a group that advocates on behalf of volunteers for Covid-19 human challenge studies. No such studies are yet being conducted, but at the time of writing, more than 24,000 people from 102 countries have signed up on the 1 Day Sooner website to express an interest in taking part in one. Globally, there have now been more than five million reported cases of Covid-19, and 300,000 deaths. Should we let people volunteer to be purposely exposed to a virus we know can sometimes be fatal?
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Read the rest of this discussion piece

Friday afternoon’s funny – Summary consent forms are troubling0

Posted by Admin in on May 29, 2020
 

Cartoon by Don Mayne www.researchcartoons.com
Full-size image for printing (right mouse click and save file)

The thinking behind summary forms are just troubling. That we have consent material that are so long and hard to read they require a summary.  And we are okay with that?  And the message potential participants only need to pay close attention to part of a consent document.  Implicit in this is that they doing somethings, such as the full consent document because they have to, not because they are important.

Multimedia in improving informed consent for caesarean section: A randomised controlled trial (Papers: Alice Truong, et al | January 2020)0

Posted by Admin in on May 28, 2020
 

Abstract
Background

Multimedia modules have been used as an adjunct to improve patient knowledge and recall for various elective surgical procedures, but have been incompletely evaluated in patients undergoing caesarean section.

Aims

To compare the use of a supplementary multimedia module with written information in improving the informed consent process prior to elective caesarean section.

Materials and methods

This was a prospective randomised controlled trial (ACTRN12616000430437). Primary outcomes were knowledge and anxiety scores immediately following the intervention and on the day of surgery. Secondary outcomes were patient satisfaction, length of stay, time to cessation of analgesia, and patient assessment of the consent types.

While this is about the use of digital media in the context of consent for a surgical procedure, it’s findings are significant for researchers across many disciplines.

Results

Seventy‐five patients completed the study. Both multimedia module and written information groups demonstrated a significant increase in knowledge scores with no difference between the groups. In the multimedia‐assisted consent group, scores improved from baseline by +2.31 (P < 0.001) immediately after watching the multimedia module and by +2.41 (P < 0.001) on the day of surgery. In the written information group, scores improved by +1.76 (P < <0.001), and +2.31 (P < 0.001) respectively. There was no adverse impact on anxiety in either group. Patient‐reported understanding (92.4% vs 78.5%, P = 0.001), and helpfulness (90.1% vs 73.3%, P = 0.001) was significantly higher in the multimedia module group than in the written information group. The multimedia module was assessed as ‘slightly too long’ and provided ‘slightly too much information’.
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Conclusions

Multimedia modules are a valuable adjunct to traditional processes of obtaining informed consent for elective caesarean section and should be offered and made available to patients prior to surgery.
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Keywords

anxiety, caesarean section, informed consent, knowledge, multimedia
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Truong, A., Ellett, L., Hicks, L., Pell, G. and Walker, S.P. (2020), Multimedia in improving informed consent for caesarean section: A randomised controlled trial. Aust N Z J Obstet Gynaecol. doi:10.1111/ajo.13124

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