Consent: a Cartesian ideal? Human neural transplantation in Parkinson's disease.
Identifieur interne : 001101 ( PubMed/Curation ); précédent : 001100; suivant : 001102Consent: a Cartesian ideal? Human neural transplantation in Parkinson's disease.
Auteurs : Manuel Lopes [France] ; Jean-Paul Meningaud ; Anthony Behin ; Christian HervéSource :
- Medicine and law [ 0723-1393 ] ; 2003.
Descripteurs français
- Wicri :
- geographic : France.
English descriptors
- KwdEn :
- Attitude to Health, Cell Transplantation (psychology), Ethics, Clinical, Ethics, Research, France, Humans, Informed Consent (legislation & jurisprudence), Nerve Tissue (cytology), Nerve Tissue (transplantation), Parkinson Disease (diagnosis), Parkinson Disease (psychology), Parkinson Disease (surgery), Surveys and Questionnaires, Therapeutic Human Experimentation (ethics), Treatment Outcome.
- MESH :
- geographic : France.
- cytology : Nerve Tissue.
- diagnosis : Parkinson Disease.
- ethics : Therapeutic Human Experimentation.
- legislation & jurisprudence : Informed Consent.
- psychology : Cell Transplantation, Parkinson Disease.
- surgery : Parkinson Disease.
- transplantation : Nerve Tissue.
- Attitude to Health, Ethics, Clinical, Ethics, Research, Humans, Surveys and Questionnaires, Treatment Outcome.
Abstract
The grafting of human embryonic cells in Parkinson's disease is an innovative and hopefully useful therapeutic approach. However, it still concerns a very small number of patients and is only suggested as a research protocol. We present here a study of the problems of information and consent to research within the framework of this disease in which the efficacy of medical treatment is shortlived. The only French center to use this treatment (Hôpital H. Mondor in Créteil) has received authorization from the Comité Consultatif National d'Ethique (Consultative National Committee on Ethics). Eleven patients were treated between 1991 and 1998. The study of the results of a questionnaire sent to those patients showed the difficulties met in evaluating the perception of information despite intact intellectual capacities in people "prepared to risk everything." In France, the duty to inform patients during research procedures is regulated by the Huriet Act. However, it is not easy to guarantee genuine consent when preliminary information is given to patients psychologically impaired by the slow and ineluctable course of their disease. In these borderline cases, a valid consent seems to be a myth in terms of pure autonomy when considered with the Cartesian aim of elimination of uncertainty. The relevance of this concept of genuine consent probably makes more sense as aiming at a Cartesian ideal which is perhaps more in the spirit rather than in the letter. It is in that same spirit that, from the outset, we propose to define t he practical ways of answering the patients' request for information, even sometimes after consent has been given.
PubMed: 12809343
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<front><div type="abstract" xml:lang="en">The grafting of human embryonic cells in Parkinson's disease is an innovative and hopefully useful therapeutic approach. However, it still concerns a very small number of patients and is only suggested as a research protocol. We present here a study of the problems of information and consent to research within the framework of this disease in which the efficacy of medical treatment is shortlived. The only French center to use this treatment (Hôpital H. Mondor in Créteil) has received authorization from the Comité Consultatif National d'Ethique (Consultative National Committee on Ethics). Eleven patients were treated between 1991 and 1998. The study of the results of a questionnaire sent to those patients showed the difficulties met in evaluating the perception of information despite intact intellectual capacities in people "prepared to risk everything." In France, the duty to inform patients during research procedures is regulated by the Huriet Act. However, it is not easy to guarantee genuine consent when preliminary information is given to patients psychologically impaired by the slow and ineluctable course of their disease. In these borderline cases, a valid consent seems to be a myth in terms of pure autonomy when considered with the Cartesian aim of elimination of uncertainty. The relevance of this concept of genuine consent probably makes more sense as aiming at a Cartesian ideal which is perhaps more in the spirit rather than in the letter. It is in that same spirit that, from the outset, we propose to define t he practical ways of answering the patients' request for information, even sometimes after consent has been given.</div>
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<Abstract><AbstractText>The grafting of human embryonic cells in Parkinson's disease is an innovative and hopefully useful therapeutic approach. However, it still concerns a very small number of patients and is only suggested as a research protocol. We present here a study of the problems of information and consent to research within the framework of this disease in which the efficacy of medical treatment is shortlived. The only French center to use this treatment (Hôpital H. Mondor in Créteil) has received authorization from the Comité Consultatif National d'Ethique (Consultative National Committee on Ethics). Eleven patients were treated between 1991 and 1998. The study of the results of a questionnaire sent to those patients showed the difficulties met in evaluating the perception of information despite intact intellectual capacities in people "prepared to risk everything." In France, the duty to inform patients during research procedures is regulated by the Huriet Act. However, it is not easy to guarantee genuine consent when preliminary information is given to patients psychologically impaired by the slow and ineluctable course of their disease. In these borderline cases, a valid consent seems to be a myth in terms of pure autonomy when considered with the Cartesian aim of elimination of uncertainty. The relevance of this concept of genuine consent probably makes more sense as aiming at a Cartesian ideal which is perhaps more in the spirit rather than in the letter. It is in that same spirit that, from the outset, we propose to define t he practical ways of answering the patients' request for information, even sometimes after consent has been given.</AbstractText>
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