CONFLICT OF INTEREST, INFORM CONCERNT & CONFIDENTIALITY

Aman UllahB.Sc. Med. Lab. TechnologyM. Phil. MicrobiologyCertificate in Health Professional Education Lecturer, Department of Medical Lab. TechnologyInstitute of Paramedical Sciences, Khyber Medical University, Peshawar, Pakistan

ALERT: THE MATERIALS INCLUDED IN THIS PRESENTATION WAS ACTUALLY COMPILED BY DR. TASLEEM AKHTARIN THE CONTACT SESSION OF MASTER IN HEALTH RESEARCH AT KHYBER MEDICAL UNIVERSITY, PESHAWAR, PAKISTAN

Conflict of Interest

Ethical issues can arise when research activities and other activities conflict.

A conflict of interest occurs when secondary interests—such as teaching, administration, political advocacy, or financial or a vocational pursuits—distort the integrity ofjudgments regarding the primary interest-research.TRI-COUNCIL POLICY STATEMENT 2010-Canada

Failure to disclose and manage conflicts may impede the informed and autonomous choices of individuals to participate in research.

Conflicts of interest may also undermine the respect for participants that is fundamental to the principle of Justice.

TRI-COUNCIL POLICY STATEMENT 2010-Canada

Institutional Conflict of Interest

Institutions involved in research hold trust relationships with participants, research sponsors, researchers and society.

These institutions may have financial or reputational interests that conflict with theinstitution’s obligations to protect and respect human dignity

TRI-COUNCIL POLICY STATEMENT 2010-Canada

IERC/B Member Conflict of Interest

The IERC/B, as an entity, or in the persons of the members who make up the board, also hold trust relationships with participants, research sponsors, researchers and society.

IERC/B members must also be aware of their own potential for real or perceived conflicts of interest. Contd.

For example,

IERC/B members are in a conflict of interest when:

•their own research projects are under review by their IERC/B,

•when they are a co-investigator, or •when they are in a supervisory or mentoring relationship with a graduate student applicant.

Researcher Conflict of Interest

Researchers and research students hold trust relationships, either directly or indirectly, with participants, research sponsors, institutions, their professional bodies and society.

These trust relationships can be put at risk by conflicts of interest that may compromise independence, objectivity or ethical duties of loyalty. contd

Researchers’ conflicts of interest may arise from interpersonal relationships, financial partnerships, other economic interests, academic interests or any other incentives that may compromise integrity or respect for the core principles of research ethics

Conflicts may arise from an individual’s involvement in dual and multiple roles within or outside an institution.

Respect for the autonomy of the research participant/patient would, in common parlance, mean that the patient has the capacity to act intentionally, with understanding, and without controlling influences

This principle is the basis for the practice of "informed consent"

What is informed consent?

Informed consent is the process by which a fully informed patient can participate in choices about her/his health care.

Types of Informed Consent:

•Full Informed consent

•Basic Informed consent

Full Informed consent

The most important goal of informed consent is that the patient has an opportunity to be an informed participant in her/his health care decisions.

Complete informed consent includes a discussion of the following elements:

•the nature of the decision/procedure •reasonable alternatives to the proposed intervention •the relevant risks, benefits, and uncertainties related to each alternative •assessment of patient understanding •the acceptance of the intervention by the patient

Basic consent:

Basic consent entails letting the patient know what you would like to do and asking them if that will be all right.

Basic consent is appropriate, for example, when drawing blood.

A low-level of patient involvement is needed because there is a high-level of community consensus.

What should occur if the patient cannot give informed consent?

A surrogate decision maker must speak for her/him.

There is a specific hierarchy of appropriate decision makers defined by law.

If no appropriate surrogate decision maker is available, the physicians can act in the best interest of the patient

Is there such a thing as presumed/implied consent?

The patient's consent should only be "presumed", rather than obtained, in emergency situations when the patient is unconscious or incompetent and no surrogate decision maker is available.

Contd.

The patient's presence in the hospital ward, ICU or clinic does not represent implied consent to all treatment and procedures

While the principle of autonomy and the principle of beneficence have to be balanced in emergency situations

Who has the authority to make decisions for children?

Parents

This includes the right to refuse or discontinue treatments, even those that may be life-sustaining.

Parental decision-making should be guided by the best interests of the child.

Decisions that are clearly not in a child's best interest can and should be challenged.

Confidentiality is a set of rules or a promise that limits access or places restrictions on certain types of information

Medical Confidentiality

Confidentiality is commonly applied to conversations between doctors and patients. Legal protections prevent physicians from revealing certain discussions with patients, even under oath in court

Traditionally, medical ethics has viewed the duty of confidentiality as a relatively non-negotiable tenet of medical practice.

In the UK information about an individual's HIV status is kept confidential within the NHS. This is based in law, in the NHS Constitution and in key NHS rules and procedures. 

A healthcare worker can share personal information without consent if it is in the public interest.

These instances are set out in guidance from the General Medical Council which is the regulatory body for doctors.

Sometimes the healthcare worker has to provide the information - if required by law or in response to a court order.

QUESTIONS/SUGGESTIONSKHURRAMTHALWI@HOTAMAIL.COM