Informed consent and informed refusal: A developing country perspective

Abstract

The attitude of clinicians, from the countries with different cultures, legal systems and economic situation, to informed consent (and informed refusal) is not the same. Some of them take the duty to inform the patient and the consenting process seriously; others consider informed consent just as a mere formality. Proper understanding of the essence of informed consent and its attributes and peculiarities, depending on the type of medical care or research, is far more important for health-care professionals from developing countries where considerable attention to human rights in health care has started to emerge. The issues arising in connection with the receipt and documentation of informed consent (informed refusal) are exemplified based on the legislation and practice of Ukraine. Fundamental elements of informed consent and the actions that need to be taken by the health-care professional to ensure their availability are discussed. Much attention is paid to the ways of expressing informed consent. The issues of withdrawal of informed consent and refusal from a medical intervention are also considered. The inadmissibility of emasculating the idea of informed consent and transforming informed consent (informed refusal) into a legal fiction is pointed out. The improvements that need to be introduced in legislation and practice for ensuring that informed consent (informed refusal) performs its functions are also discussed.