Observations on respecting the informed consent right for either competent or vulnerable subjects

摘要

Informed consent is one of the most sensitive issues of the physician-patient, researcher-subject (or research participant, term recently recommended by some specialists in bioethics to be used instead of subject) relationship. A review of the reflections, some of them materialized during the time in documents and regulations, on this essential right of the patient or research participant, is subject to a long history and to a permanent review. The “Nurnberg Code”, adopted after the 2nd World War, in 1947, was a major bench-mark in time defining of the Patient Rights’ Chart, Statement that was adopted in 1994, in Amsterdam, on the occasion of European Consultation. The author, from the perspective of his experience in medicine (geriatrics, psycho-geriatrics, incurable diseases – palliative care) and also from his experience in bioethics (Romanian National Committee for Bioethics – UNESCO), brings to attention his own casuistry, commenting on different aspects of consent rights violation. Based on the same perspectives, the author makes some suggestions regarding the conditions of the consent right’s exertion, arguing that, beyond the information condition, there are also other conditions that would make a real consent to be informed, individual and free. Thus, some ambiguous situations of formal consent obtained under pressure or even ignored are eliminated, as it is illustrated in the casuistry presented.