I just read the article by Aisha Malik "Physician-researchers’ experiences of the consent process in the socio-cultural context of a developing country", and think it raises some very interesting points. I have seen similar issues in some of the research I have participated in. Whenever there is a lack of education, patients will often readily consent to whatever the doctor says. So if the doctor asks them if they wish to participate in research, they will say yes - without understanding what exactly they've agreed to. They say yes because they think that is the 'correct' answer, and that if this is something the doctor is proposing, it must be good. Does anyone have any suggestions on how to ensure that consent is truly voluntary?
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To ensure consent is voluntary, you must know the community. You have to understand the context in which your research participants live. Otherwise your participants will just say yes, even if they mean no. In another discussion in this group, they talked about 'silent refusal'. It might help you to look at that:
http://globalhealthbioethics.tghn.org/community/groups/group/eth_con/topics/69/ -
The article referred to above can be accessed from this website at:
http://globalhealthbioethics.tghn.org/articles/physician-researchers-experiences-consent-process-socio-cultural-context-developing-country/
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