Importance of Language in Consent

In our class we have spent a lot of time discussing and unpacking the idea of consent. We spent an entire class learning about the Institutional Review Board. Throughout the reading of Harriet Washington’s Medical Apartheid we saw many unfortunate examples of consent not being given. We even spent a large amount of time discussing consent with regards to medical voluntourism. Needless to say, consent has been an important aspect of the course. Another focus of the course has been the importance of language and word choice. These two, consent and the important of language, go hand in hand.

Words are powerful. They have the power to give somebody the permission to do something or in other cases to not give somebody the permission to do something. It is also crucial that the words used to obtain consent or that are being used to give consent are clear the other person. In section 37. of the FAQ of the Institutional Review Board it says” to ensure that the consent document, in its entirety, contains all the information required by 21 CFR 50.25 in language the subject can understand.”. The portion of this that says in language that can be understood is absolutely crucial. This is where word choice becomes extremely important. If you are trying to obtain consent you must communicate clearly what exactly is going to be done and to what extent. It is also important to note that consent needs to be obtained if the procedure changes from it’s plan. “Clinical investigators should be cautious when enrolling subjects who may not truly understand what they have agreed to do. (Section 40 FAQ of the IRB). In Medical Apartheid Harriet Washington dedicates a chapter called “The Erosion of Consent”. An interesting point that she makes is “Various ethicists who are experts in human medical experimentation, such as Jay Katz, M.D and George Annas, J.D., worry that the vague language of federal regulations governing human medical experimentation is being interpreted in a manner that minimizes protections. (Washington 397). This is yet another example of how word choice is absolutely vital when obtaining consent. Intelligent people manipulated innocent, vulnerable people with their words. In some cases these people did not even ask for the patient’s consent due to loopholes in federal laws. Again, these loop holes are due to the wording of a law. I now understand why Professor McCoy stresses the importance of appropriate word choice being able to defend why you chose a particular word.

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