Informed consent for research: international perspectives.

Problems in obtaining and documenting informed consent are especially difficult to resolve in countries whose cultures differ considerably from those of most Western nations. Confusion between the research and therapeutic contexts are widespread. Two departures from widely accepted ethical standards are discussed: withholding information about the research and requiring a husband's permission for his wife to participate. Supporters of such departures claim that they are justified by the cultural context of the country in which the research is carried out. One program at the World Health Organization has developed guidelines stating that requiring partner agreement or authorization for an individual to participate in research violates the autonomy of research subjects and their right to confidentiality. A study carried out at one reproductive health clinic in Chile describes a process of obtaining informed consent to research that could serve as a model for US investigators interested in making informed consent a meaningful and ethically respectable aspect of their research activities. Research involving human subjects should adhere to a single, universally applicable standard of informed decision making by participants.

[Liberty, justice, and the common good: ethical focus on unwanted pregnancy]. / Libertad, bien comun y justicia: enfoque etico del embarazo indeseado.

PIP: A professor of bioethics discusses the ethics of abortion. Three absolute principles from the tradition of Western moral philosophy constitute the ethical basis for treatment of unwanted pregnancy. The principle of individual freedom guarantees the right to freedom of decision and action. The principle of the common good defines as morally correct the policy or action that most benefits the majority, and the principle of justice establishes that all individuals should have equal access to needed goods and services. Each of these principles is discussed as it relates to abortion, and potential conflicts and controversies are assessed in accordance with the principles. The three principles require application of the moral mandate of tolerance for the beliefs and practices of others, a necessity for coexistence in a pluralistic world. A series of natural and social rights may also be invoked, notably the right to decide freely and responsibly the number and timing of children and the right of access to the information and materials making this possible, which were affirmed in the 1974 World Population Conference at Bucharest in a statement signed by representatives of 136 governments. Universal agreement on ethical matters is unlikely to occur in a plural world. Different persons may recognize different priorities when ethical principles are in competition. The most difficult conflict is probably that between the rights of the woman and those of the fetus. This conflict differs from most others in that the legitimacy of the fetus as a bearer of rights may be questioned. Extremist positions whether motivated by religious or political factors are based on dogmas or doctrines that resist rational analysis. Applying the three principles to the problem of unwanted pregnancy, it is concluded that women have a natural right to reproductive freedom and a social right to family planning and abortion services.^ieng