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Gehlert S, Mozersky J. Seeing Beyond the Margins: Challenges to Informed Inclusion of Vulnerable Populations in Research. THE JOURNAL OF LAW, MEDICINE & ETHICS : A JOURNAL OF THE AMERICAN SOCIETY OF LAW, MEDICINE & ETHICS 2018; 46:30-43. [PMID: 30093794 PMCID: PMC6077979 DOI: 10.1177/1073110518766006] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Although the importance of including vulnerable populations in medical research is widely accepted, identifying how to achieve such inclusion remains a challenge. Ensuring that the language of informed consent is comprehensible to this group is no less of a challenge. Although a variety of interventions show promise for increasing the comprehensibility of informed consent and increasing a climate of exchange, consensus is lacking on which interventions should be used in which situations and current regulations provide little guidance. We argue that the notion of individual autonomy — a foundational principle of informed consent — may be too narrow for some vulnerable populations by virtue of its failure to acknowledge their unique histories and current circumstances. It has a different meaning for members of structured groups like American Indians than for unstructured groups, such as African Americans, whose complicated histories foster group identity. Ensuring broad participation in research and selecting appropriate methods for obtaining informed consent — namely, methods aligned with the source of vulnerability and level of risk — require new ways of thinking that might produce guidelines for matching informed consent models and processes with subpopulations.
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Affiliation(s)
- Sarah Gehlert
- Sarah Gehlert, Ph.D., is the E. Desmond Lee Professor of Racial and Ethnic Diversity at Washington University in St. Louis. She holds an M.A. in Anthropology and an M.S.W. from the University of Missouri-Columbia and a Ph.D. in Social Work from Washington University (St. Louis). Jessica Mozersky, Ph.D., is an Assistant Professor at Washington University in St. Louis. She holds an M.B.E. from the University of Pennsylvania and a Ph.D. in Anthropology from University College London's Interdisciplinary Institute for Human Genetics and Health
| | - Jessica Mozersky
- Sarah Gehlert, Ph.D., is the E. Desmond Lee Professor of Racial and Ethnic Diversity at Washington University in St. Louis. She holds an M.A. in Anthropology and an M.S.W. from the University of Missouri-Columbia and a Ph.D. in Social Work from Washington University (St. Louis). Jessica Mozersky, Ph.D., is an Assistant Professor at Washington University in St. Louis. She holds an M.B.E. from the University of Pennsylvania and a Ph.D. in Anthropology from University College London's Interdisciplinary Institute for Human Genetics and Health
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Reel K. Clinical considerations for allied professionals on research ethics--Vulnerable research participant populations: ensuring ethical recruitment and enrolment. Heart Rhythm 2011; 8:947-50. [PMID: 21215821 DOI: 10.1016/j.hrthm.2011.01.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2010] [Indexed: 10/18/2022]
Affiliation(s)
- Kevin Reel
- Southlake Regional Health Centre, Newmarket, Ontario, Canada.
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