Medicine and law
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Informed consent for research in psychiatry raises a number of ethical and legal issues. To illustrate some of the ethical problems involved, in particular issues of patient competence and proxy consent, as well as the motives of patients to become research participants, as an example the case of so-called medication-free research in schizophrenia is discussed. ⋯ In case of substituted consent it is shown that proxy decision makers may fail to protect the interests of incompetent patients in research. Finally, researchers ought to be aware that research subjects may be motivated to participate in research because they may mistakenly believe that the research project is designed to benefit them directly.
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Although several international and regional human rights instruments, including the Universal Declaration of Human Rights and the International Covenant on Economic, Social and Cultural Rights, give explicit recognition to a broad right to health, this right, at present, offers little real protection to interests in individual and community health, including reproductive and sexual health. This is so, the author argues, because the mechanisms now in place for supervision and enforcement of this and other "social human rights" are extremely weak. In these circumstances, better protection is available indirectly, through enforcement of certain "classical human rights," such as the right to life, the right to be free from inhuman and degrading treatment, and the right to found a family, that contribute to--and depend upon--realisation of a right to health.