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Published on: September 19, 2011
Presence of both parents during consent process in non-therapeutic neonatal research increases positive response
Irina Korotchikova1, Geraldine B Boylan, Eugene M Dempsey
1Department of Paediatrics and Child Health, University College Cork, Ireland. I.Korotchikova@ucc.ie
Insights
Parental consent for neonatal electroencephalogram (EEG) research is higher when both parents are present. Understanding and perceived harm significantly influence decisions regarding non-therapeutic infant studies.
Area of Science:
- Neonatal research ethics
- Clinical neurophysiology
Background:
- Ethical considerations are paramount in pediatric research.
- Informed consent in neonatal studies presents unique challenges.
Purpose of the Study:
- To identify factors influencing parental consent and non-consent for a non-therapeutic electroencephalogram (EEG) study in healthy newborns.
- To analyze reasons for refusal or withdrawal of consent in neonatal research.
Main Methods:
- Parents of healthy newborns were approached for a neonatal EEG study.
- Informed consent procedures included detailed explanations of rationale, risks, and benefits.
- Parents who refused or withdrew consent were interviewed to understand their reasons, categorized by consent principles.
Main Results:
- Consent was obtained in 59% of cases; 8% withdrew consent, and 33% refused.
- Consent rates were significantly higher when both parents were present (p < 0.0001).
- Approaching mothers alone within 6 hours of delivery resulted in lower consent rates (37% vs. 67%, p = 0.009).
- Primary reasons for refusal included understanding (54%) and competence (29%).
Conclusions:
- Parents generally hold a positive attitude towards non-therapeutic neonatal research.
- Maximal consent rates were observed when both parents participated in the decision-making process.
- Perceived harm to the infant was a significant factor in parental non-consent.
Aim:
To investigate factors that influenced parental consent/non-consent in a non-therapeutic electroencephalogram (EEG) study in healthy newborns.
Methods:
Parents of healthy newborns were approached to participate in a neonatal EEG study within 36 h of birth. The rationale and risks/benefits of the study were explained. Any concerns were discussed, and detailed information about the EEG study was provided in the consent form. In the case of refusing/withdrawing consent, an informal interview was used to investigate the reasons, which were subsequently analysed and grouped according to the four principles of the consent process.
Results:
A total of 123 parents were included in the study. Parental consent was obtained in 72/123 (59%) cases, 10/123 (8%) parents subsequently withdrew their consent and 41/123 (33%) parents refused to participate in the study. Consent was more likely if both parents were present (p < 0.0001). When the mothers were approached alone, obtaining consent was significantly more difficult within the first 6 hours of delivery, compared to a later approach (37% vs. 67% respectively; p = 0.009). Refusals were classified into issues of voluntariness (7%), informed choice (10%), understanding (54%) and competence (29%).
Conclusion:
Parents of healthy newborns demonstrated a positive attitude towards non-therapeutic neonatal research with maximal consent occurring when both parents were present. Parental perception of harm was the main reason for declining consent.
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