Informed consent and the capacity for voluntarism.

Area of Science:

• Bioethics
• Psychiatry
• Informed Consent

Background:

• Informed consent relies on information, decisional capacity, and volunteerism.
• Voluntarism is the least understood element, hindering ethical problem resolution in psychiatry.
• Improved understanding of voluntarism is essential for ethical clinical and research practices.

Purpose of the Study:

• To define and explore the concept of voluntarism in clinical and research consent.
• To develop a framework for assessing voluntarism in consent decisions.
• To address ethical challenges related to voluntarism in psychiatry.

Main Methods:

• Conceptual analysis of voluntarism in consent.
• Definition of voluntarism encompassing authentic action, freedom from coercion, deliberateness, and coherence.
• Illustration of a framework for voluntarism in consent decisions.

Main Results:

• Voluntarism is defined as acting authentically according to one's values, freely and without coercion.
• A framework for voluntarism in consent is proposed, considering four domains of influence.
• These domains include developmental, illness-related, psychological/cultural, and external factors.

Conclusions:

• Enhanced understanding of voluntarism supports the ethical principle of respect for persons.
• This framework aids in resolving ethical issues in clinical and research consent.
• Improved voluntarism assessment contributes to more ethical patient care and research participation.