Informed Consent
Indigenous population pose a significant risk to the health care delivery due to the stark differences that they reflect in their culture and tradition. It has to be mentioned in this context that the culturally diverse patient groups often experience a significant inequality in the care experience and delivery (Hall, Prochazka & Fink, 2012). One great aspect of care delivery which has encountered considerable challenges when involving the indigenous community is the informed consent, an integral component of patient centred care delivery and ethical aspects of care. This presentation will allow me to illustrate the aspect of informed consent and how it applies to the culturally diverse population of indigenous individuals.
Informed consent can be defined in the health care context as the process of acquiring the permission from a patient respectfully before conducting a healthcare intervention or assessment activity. However, in the aspects of health care, the informed consent is also used as the implementation of an ethical course of activity which allows the professional to take permission before he or she can disclose any personal information (Grady, 2015).
It has to be mentioned that informed consent has become of the greatest aspects of clinical treatment which is practiced all across the globe and is a vital component of the contemporary medical practice. Delving deeper into the ideation of the informed consent, it has to be mentioned that this particular component is associated with three overarching components of care delivery procedure, legal, ethical, and administrative compliance.
Here I would like to explain the fact that in context of legal aspects, informed consent allows the patient to have a mandatory right to claim the choices and preferences. Hence, the care professional taking part in the process of informed consent will have the chance to allow the patient to have a priority basis of decision making power to either allow or refuse any care activity (Faden, Beauchamp & Kass, 2014).
This also is overlapped with the ethical aspects of the care delivery context, it has to be mentioned that the patients have an autonomous right decision making and take equal part in the establishment of the defined goals. The informed consent automatically co-relates both of the aspects in care setting or scenario. Elaborating more, while asking for informed consent, patients are asked whether or not they want to take part in the care activities. Hence, this particular activity immediately takes into consideration giving the patient autonomous decision making power and helps in re-orienting the care goal setting into a more patient defined genre.
Informed consent has multidimensional benefits, and administrative compliance is the next most effective benefit of this ethico-legal component. Yoshizawa et al. (2017) have discussed that informed consent is a written legal document that takes into consideration that is a proof of all the parties being involved with the procedure. Along with that the informed consent document also allows the care professionals to have an effective safeguard that allows nominal fulfilment of the ethical and legal requirements of care delivery procedure.
Informed Consent for Aboriginals
Informed consent is an ethical and legal requirement for conducting any research or treating any patient in the clinical setting. Informed consent is an inevitable requirement before any procedure of diagnosis or treatment is undertaken in the clinical setting. It provides the liberty to every participant for deciding whether to refuse or accept the recommended treatment. However, obtaining informed consent and maintaining confidentially of the patient become increasingly challenging while treating the indigenous population (Ashmran et al., 2016). The challenges are growing in several directions which significantly affect the health of the indigenous population, especially women in the population. A study suggested that language is one of the prime barriers for seeking informed consent from aboriginal women of Torres Strait island (Orozco et al., 2017). In the majority of the cases, the individual who signs the consent letter form does not have the full understanding of the statement started in the form. Therefore, the procedure hinders the effective treatment interventions of the disease. Misunderstanding is another evident barrier due to incorrect language translation by a translator. In a majority of the cases, individuals sign the consent form without unaware of the content of the form which results in the withdrawal of the consent at the later stage of the treatment procedure (Regmi et al., 2017). Informed consent for giving liberty to every individual for choosing their choice of recommended treatment. However, in a considerate case, the decision is influenced by religious beliefs, and it becomes an area of conflict for proceeding with accurate treatment (Varcoe et al 2017).
Consequently, the mortality rate and burden of the diseases increases exponentially as compared to the modern part of the country. Moreover, the religious beliefs and language barriers are dissolved; sometimes the false expectation and past experiences become massive barriers to treatment procedure. Personal beliefs also influence the agreement of informed consent. A significant number of individuals tend to think that conventional treatment is the best way of curing any disease and refuse to receive any recommended treatment out of the conventional treatment. Thus, it influences the health crisis of the population and the majority of the individual suffers from the incurable disease. Lack of sound knowledge about the topic significantly influences their refusal in giving the informed consent for proceeding with the treatment. Sometimes, it may happen that the physician or nurses or interviewer belong to the non-indigenous part of the country and have no knowledge of the religion and personal beliefs. Therefore, the approaches towards the patient who belong to the original part of the country are not up to the expectation. Consequently, the patients feel offended and refuse to provide the consent for the treatment, and the burden of health crisis increases exponentially. Therefore, seeking informed consent is difficult to obtain for the indigenous women and may require special care for obtaining the informed consent.
The informed consent is undoubtedly a very important aspect of the care delivery scenario, it is not just an ethical form to fill, it is a legislative component, missing out on which can lead to professional issues and can lead to penalizing the health care professional associated with it. The indigenous populations on the other hand are associated with many language and culture oriented barriers which further complicates the care delivery scenario for the minority target patient group. It has to be mentioned that the language and cultural differences are associated with various barriers and challenges in care delivery scenario for the patient groups. For aboriginals, the culture and tradition also differs drastically in accordance to the care delivery scenario (Blum & Murray, 2016). A lot of activities are considered disrespectful and offending in the aboriginal populations and the informed consent provides the chance to the aboriginals to check beforehand the aspects of care before agreeing to it. It has to be mentioned that however, the language problem and the aspects of care is undoubtedly a grave concern which complicates the process of informed consent from the culturally diverse patients. This allows health care professionals like us to understand what skills need to be further developed to allow the informed consent process to be completed accordingly, even for culturally diverse population (Castellano, 2014).
Relation and Discussion
This presentation had given me the optimal opportunity to understand how, informed consent, one of the most important ethico-legal aspects of care delivery, plays into health care scenario for aboriginal patient groups. The barriers and challenges that are prevailing in the scenario has given me a clear ideation regarding the need for more culturally appropriate communication skills and approach of tone. I have gathered a wealth of knowledge that would help me in the future to develop the exact action plans which will help me in the future to understand how to effectively and successfully carry out patient informed consent procedure. The research carried out for the presentation had been mostly based on Google scholar and the data gathered had been accumulated precisely by me. This experience also helped me discover how to carry out evidence based practice in the future as well.
Conclusion:
On a concluding note, this has to be mentioned that this activity helped me identify exactly how to carry out a detailed literature search and develop a detailed account of the ethical topic chosen for the assignment with respect to my specialty area, the aboriginal care delivery. There are a few considerable barriers that I have identified that hinders effective informed consenting among the aboriginals. It can be hoped that the experience and knowledge gained from this activity will help me improve the cultural appropriateness of my practice and will help me adhere to the ethical and legal aspects effectively.
References:
Ashman, A. M., Collins, C. E., Weatherall, L., Brown, L. J., Rollo, M. E., Clausen, D., … & Lumbers, E. R. (2016). A cohort of Indigenous Australian women and their children through pregnancy and beyond: the Gomeroi gaaynggal study. Journal of developmental origins of health and disease, 7(4), 357-368.
Blum, A., & Murray, S. J. (Eds.). (2016). The ethics of care: Moral knowledge, communication, and the art of caregiving. Routledge.
Castellano, M. B. (2014). Ethics of Aboriginal Research1. Global bioethics and human rights: Contemporary issues, 273.
Faden, R. R., Beauchamp, T. L., & Kass, N. E. (2014). Informed consent, comparative effectiveness, and learning health care. N Engl J Med, 370(8), 766-768.
Grady, C. (2015). Enduring and emerging challenges of informed consent. New England Journal of Medicine, 372(9), 855-862.
Hall, D. E., Prochazka, A. V., & Fink, A. S. (2012). Informed consent for clinical treatment. Canadian Medical Association Journal, 184(5), 533-540.
Orozco, F., Ochoa, D., Muquinche, M., Padro, M., & Melby, C. L. (2017). Awareness, Comprehension, and Use of Newly-Mandated Nutrition Labels Among Mestiza and Indigenous Ecuadorian Women in the Central Andes Region of Ecuador. Food and nutrition bulletin, 38(1), 37-48.
Regmi, P. R., Aryal, N., Kurmi, O., Pant, P. R., Van Teijlingen, E., & Wasti, S. P. (2017). Informed consent in health research: challenges and barriers in low?and middle?income countries with specific reference to Nepal. Developing world bioethics, 17(2), 84-89
Varcoe, C., Browne, A. J., Ford?Gilboe, M., Dion Stout, M., McKenzie, H., Price, R., … & Khan, K. (2017). Reclaiming Our Spirits: Development and pilot testing of a health promotion intervention for Indigenous women who have experienced intimate partner violence. Research in nursing & health, 40(3), 237-254.
Yoshizawa, G., Sasongko, T. H., Ho, C. H., & Kato, K. (2017). Social and communicative functions of informed consent forms in East Asia and beyond. Frontiers in genetics, 8, 99.
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