• We are sorry, but NCBI web applications do not support your browser and may not function properly. More information
Logo of jmedethJournal of Medical EthicsCurrent TOCInstructions to authors
J Med Ethics. Oct 2002; 28(5): 313–317.
PMCID: PMC1733638

Why we should not seek individual informed consent for participation in health services research


Ethics committees now require that individuals give informed consent to much health services research, in the same way as for clinical research. This is misguided. Existing ethical guidelines do not help us decide how to seek consent in these cases, and have allowed managerial experimentation to remain largely unchecked. Inappropriate requirements for individual consent can institutionalise health inequalities and reduce access to services for vulnerable groups. This undermines the fundamental purpose of the National Health Service (NHS), and ignores our rights and duties as its members, explored here. Alternative forms of community consent should be actively pursued.

Full Text

The Full Text of this article is available as a PDF (91K).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Scholes D, Stergachis A, Heidrich FE, Andrilla H, Holmes KK, Stamm WE. Prevention of pelvic inflammatory disease by screening for cervical chlamydial infection. N Engl J Med. 1996 May 23;334(21):1362–1366. [PubMed]
  • Biro M, Lumley J. The safety of team midwifery: the first decade of the Monash Birth Centre. Med J Aust. 1991 Oct 7;155(7):478–480. [PubMed]
  • Waldenström U, McLachlan H, Forster D, Brennecke S, Brown S. Team midwife care: maternal and infant outcomes. Aust N Z J Obstet Gynaecol. 2001 Aug;41(3):257–264. [PubMed]
  • Gatta G, Capocaccia R, Sant M, Bell CM, Coebergh JW, Damhuis RA, Faivre J, Martinez-Garcia C, Pawlega J, Ponz de Leon M, et al. Understanding variations in survival for colorectal cancer in Europe: a EUROCARE high resolution study. Gut. 2000 Oct;47(4):533–538. [PMC free article] [PubMed]
  • Gatta G, Capocaccia R, Coleman MP, Gloeckler Ries LA, Hakulinen T, Micheli A, Sant M, Verdecchia A, Berrino F. Toward a comparison of survival in American and European cancer patients. Cancer. 2000 Aug 15;89(4):893–900. [PubMed]
  • Roman E, Doyle P, Maconochie N, Davies G, Smith PG, Beral V. Cancer in children of nuclear industry employees: report on children aged under 25 years from nuclear industry family study. BMJ. 1999 May 29;318(7196):1443–1450. [PMC free article] [PubMed]
  • Bithell JF, Dutton SJ, Draper GJ, Neary NM. Distribution of childhood leukaemias and non-Hodgkin's lymphomas near nuclear installations in England and Wales. BMJ. 1994 Aug 20;309(6953):501–505. [PMC free article] [PubMed]
  • Verity Chris, Nicoll Angus. Consent, confidentiality, and the threat to public health surveillance. BMJ. 2002 May 18;324(7347):1210–1213. [PMC free article] [PubMed]
  • Burns T. Psychiatric home treatment. Vigorous, well designed trials are needed. BMJ. 2000 Jul 15;321(7254):177–177. [PMC free article] [PubMed]
  • Pelosi AJ, Jackson GA. Home treatment--engimas and fantasies. BMJ. 2000 Jan 29;320(7230):308–309. [PubMed]
  • Smyth MG, Hoult J. The home treatment enigma. BMJ. 2000 Jan 29;320(7230):305–308. [PMC free article] [PubMed]
  • Djuretic T, Catchpole M, Bingham JS, Robinson A, Hughes G, Kinghorn G. Genitourinary medicine services in the United Kingdom are failing to meet current demand. Int J STD AIDS. 2001 Sep;12(9):571–572. [PubMed]
  • Barry M. Ethical considerations of human investigation in developing countries: the AIDS dilemma. N Engl J Med. 1988 Oct 20;319(16):1083–1086. [PubMed]
  • Lurie P, Wolfe SM. Science, ethics, and future of research into maternal-infant transmission of HIV-1. Lancet. 1999 May 29;353(9167):1878–1880. [PubMed]
  • Science, ethics, and the future of research into maternal infant transmission of HIV-1. Perinatal HIV Intervention Research in Developing Countries Workshop participants. Lancet. 1999 Mar 6;353(9155):832–835. [PubMed]
  • Doyal L. Informed consent in medical research. Journals should not publish research to which patients have not given fully informed consent--with three exceptions. BMJ. 1997 Apr 12;314(7087):1107–1111. [PMC free article] [PubMed]
  • Smith R. Commentary: the importance of patients' consent for publication. BMJ. 1996 Jul 6;313(7048):16–16. [PMC free article] [PubMed]
  • Oxman AD, Chalmers I, Sackett DL. A practical guide to informed consent to treatment. BMJ. 2001 Dec 22;323(7327):1464–1466. [PMC free article] [PubMed]
  • Macleod U, Ross S, Twelves C, George WD, Gillis C, Watt GC. Primary and secondary care management of women with early breast cancer from affluent and deprived areas: retrospective review of hospital and general practice records. BMJ. 2000 May 27;320(7247):1442–1445. [PMC free article] [PubMed]

Articles from Journal of Medical Ethics are provided here courtesy of BMJ Group


Related citations in PubMed

See reviews...See all...

Cited by other articles in PMC

See all...


  • Cited in Books
    Cited in Books
    PubMed Central articles cited in books
  • PubMed
    PubMed citations for these articles

Recent Activity

Your browsing activity is empty.

Activity recording is turned off.

Turn recording back on

See more...