Informed Consent and Clinical Equipoise

According to Tom Beauchamp, informed consent has two philosophies. In his first explanation, Beauchamp describes informed consent as the patient’s absolute autonomy and authority (Sutrop & Lõuk, 2020). This informed consent focuses on sovereign authorization and client rights. The patient must have a substantial understanding of the condition and intentionally authorizes an intervention without any influence. In his second definition, Beauchamp describes informed consent as being policy-oriented and adhering to legal considerations. The aspects of autonomous authorization are disregarded (Sutrop & Lõuk, 2020). In his view, Beauchamp concluded that the first definition of informed consent was correct. This explanation covers all the concepts of an actual informed concept. The second meaning cannot be applied in some cases, such as when handling bioethics and patient rights. Autonomy refers to individual independence for self-governance. This principle has three primary requirements, intentionality, knowledge and sovereignty over external constraints.

Equipoise refers to a state in which a clinical researcher is truly uncertain of the therapeutic pros of any particular arm in a trial. This definition poses two understandings; first, the investigator has an ethical responsibility to change the treatment if they discover one of superior merit. The second understanding is basing the concept of equipoise on the present or impending controversy in the medical community over the chosen treatment. Freedman’s reference for clinical equipoise is based on the fact that it provides an ethical basis for medical research and clinical trials. Samuel Hellman disputes Freedman’s version of equipoise because it is overly permissive in resolving clinical research tensions. As per Freedman, the researcher should always opt for the best available clinical intervention with more therapeutic merits. In this case, the investigator solely makes the medical decision for his clients. In my opinion, I agree with Hellman’s argument on the clinical equipoise. However, Freedman was right on the ethical responsibility of choosing the best treatment available. The patient’s rights and sovereignty ought to be respected too (MacKay, 2020). Patient care cannot be decided based only on the physician’s judgement. Each individual should be given the power to decide what best suits their interests.

References

MacKay, D. (2020). Government policy experiments and the ethics of randomization. Philosophy & Public Affairs, 48(4), 319-352.

Sutrop, M., & Lõuk, K. (2020). Informed consent and ethical research. Handbook of Research Ethics and Scientific Integrity, 213-232.

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