Replacing Surrogate Decision-Making with Supported Decision-Making for Minimal Risk Research.
We advocate for a change in the way individuals with cognitive impairment are enrolled in minimal risk clinical research. We do so in the hope that such a change will lead to more cognitively impaired individuals being enrolled in research. Our proposal applies only to cases where would-be participa...
| Publicado en: | Journal of Law, Medicine & Ethics Vol. 54; no. 2; pp. 94 - 103 |
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| Autores principales: | , , , |
| Formato: | questions and answers Journal Article |
| Publicado: |
Cambridge University Press
Summer2026
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=194133290&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 194133290 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 10731105 JME jtl: Journal of Law, Medicine & Ethics issn: 10731105 maglogo: N pubinfo: dt: Summer2026 vid: 54 iid: 2 pid: 15979 pub: Cambridge University Press artinfo: ui: 194133290 194133290 194133290 10.1017/jme.2025.10192 194133290 ppf: 94 ppct: 9 formats: tig: atl: Replacing Surrogate Decision-Making with Supported Decision-Making for Minimal Risk Research. aug: au: Hawkins, Jennifer Segal, Aaron Eli Wendler, David Howard, Dana affil: Department of Philosophy, Duke University, United States sug: subj: Cognition Disorders Research, Medical Research Subjects Decision Making Research Subject Recruitment Consent (Research) Research Ethics Patient Autonomy ab: We advocate for a change in the way individuals with cognitive impairment are enrolled in minimal risk clinical research. We do so in the hope that such a change will lead to more cognitively impaired individuals being enrolled in research. Our proposal applies only to cases where would-be participants retain some interest in decision-making as well as the ability to express a decision. In these cases, we argue that the common practice whereby researchers either obtain consent from the individual or consent from a surrogate and assent from the individual, is ethically unnecessary. Instead, a process of facilitated decision-making based on SDM (supported decision-making) should be employed. Although it is possible that this process of facilitation will enable some individuals to make a capacitated choice who would not otherwise have done so, this should not be a requirement of getting to choose. In those cases where a would-be participant, despite support, fails to make a capacitated choice, the individual should still have the final say about participation. In this respect, our proposal deviates from standard practice. However, we argue that our proposal offers participants as much ethical protection as the more common procedures involving surrogates. pubtype: Academic Journal doctype: questions and answers Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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