Current through Vol. 42, No. 1, September 16, 2024
(a)
Informed consent general requirements.
(1) Research studies submitted for Oklahoma
Department of Human Services Institutional Review Board (DHSIRB) consideration
must adhere to those requirements necessary to obtain informed consent, per
45 C.F.R. §
46.116. Requirements include, but are not
limited to:
(A) obtaining consent prior to
involving a human subject in any research study;
(B) providing sufficient time that allows a
human subject the opportunity to consider and discuss whether to participate;
(C) presenting sufficient
information about the research study in an understandable and comprehensible
format; and
(D) information that
must begin with a concise and focused presentation of the key information that
is most likely to assist a prospective subject or legally authorized
representative in understanding the reasons why one might or might not want to
participate in the research.
(i) The manner
in which the key information is described and presented is reasonably
determined by the complexity of the research project. Key information elements
may include:
(I) a statement that the project
is research and participation is voluntary;
(II) a summary of the purpose of the
research, procedures, and duration of participation;
(III) reasonable, foreseeable risks or
discomforts;
(IV) reasonable,
expected benefits; and
(V)
alternative procedures or course of treatment, if any.
(ii) The key information elements of the
informed consent must be organized and presented in a way that facilitates
comprehension.
(iii) Informed
consent must present information in sufficient detail relating to the research,
and must be organized and presented in a way that does not merely provide lists
of isolated facts, but rather facilitates the prospective subject's or legally
authorized representative's understanding of the reasons why one might or might
not want to participate.
(2) Informed consent may not include any
exculpatory language through which the subject or the legally authorized
representative is made to waive or appear to waive the subject's legal rights
or releases or appears to release the investigator or other party associated
with the research study from liability for negligence.
(3) Basic elements of informed consent
include:
(A) a statement that the study
involves research, an explanation of the research purposes and the expected
duration of the subject's participation; a description of the procedures to be
followed; and identification of any procedures that are experimental;
(B) a description of any
reasonably foreseeable risks of discomforts to the subject;
(C) a description of any benefits to the
subject or to others that may reasonably be expected from the research;
(D) a disclosure of appropriate
alternative procedures or courses of treatment, if any, that might be
advantageous to the subject;
(E) a
statement describing the extent, if any, to which confidentiality of records
identifying the subject are maintained;
(F) an explanation for research involving
more than minimal risk, whether any compensation and an explanation as to
whether any medical treatments are available if injury occurs and, if so, what
they consist of or where further information may be obtained;
(G) an explanation of whom to contact for
answers to pertinent questions about the research and research subjects' rights
and in the event of a research-related injury to the subject;
(H) a statement that participation is
voluntary, refusal to participate involves no penalty or loss of benefits to
which the subject is otherwise entitled, and the subject may discontinue
participation at any time without penalty or loss of benefits to which the
subject is otherwise entitled; and
(I) one of the following statements about any
research that involves the collection of identifiable private information or
identifiable biospecimens:
(i) a statement
that identifiers might be removed from the identifiable private information or
identifiable biospecimens and that, after such removal, the information or
biospecimens could be used for future research studies or distributed to
another investigator for future research studies without additional informed
consent from the subject or the legally authorized representative, if this
might be a possibility; or
(ii) a
statement that the subject's information or biospecimens collected as part of
the research, even when identifiers are removed, is not used or distributed for
future research studies.
(4) DHSIRB enforces the general requirements
for informed consent, per
45 C.F.R. §
46.116.
(5) Except as described in (b) and (c) of
this Section, before involving a human subject in research covered by this
Part, an investigator obtains the subject's or the subject's legally authorized
representative's legally effective informed consent. The minimum requirements
of legally effective informed consent are given in the federal regulations at
45 C.F.R. §
46.116(a) through 45 C.F.R.
§ 46.116(d).
(A) Informed consent must
begin with a concise and focused presentation of the key information that is
most likely to assist a prospective subject or legally authorized
representative in understanding the reasons why one might or might not want to
participate in the research. This part of the informed consent must be
organized and presented in a way that facilitates comprehension.
(B) Informed consent must present information
in sufficient detail relating to the research, and must be organized and
presented in a way that does not merely provide lists of isolated facts, but
rather facilitates the prospective subject's or legally authorized
representative's understanding of the reasons why one might or might not want
to participate.
(C) An
investigator seeks informed consent only under circumstances that provide the
prospective subject or the legally authorized representative sufficient
opportunity to discuss and consider whether to participate and that minimize
the possibility of coercion or undue influence.
(D) The information that is given to the
subject or the legally authorized representative is in language understandable
to the subject or the legally authorized representative.
(E) The prospective subject or the legally
authorized representative must be provided with the information that a
reasonable person would want to have in order to make an informed decision
about whether to participate, and an opportunity to discuss that information.
(6) On a case-by-case
basis, the DHSIRB may determine that other information, in addition to that
specifically mentioned in the federal regulation at
45 C.F.R. §
46.116, is given to the subjects when in the
DHSIRB's judgment the additional information would meaningfully add to the
subjects' protection of the rights and welfare.
(A) The DHSIRB makes this determination based
on the nature of the research as well as the local research context.
(B) If the DHSIRB determines that additional
elements are appropriate, this additional information is considered as
essential as the basic elements of informed consent described in the federal
Department of Health and Human Services (HHS) regulations at
45 C.F.R. §
46.116(b).
(b)
Broad consent
in lieu of informed consent. The DHSIRB may permit broad consent for the
storage, maintenance, and secondary research use of identifiable private
information or identifiable biospecimens, collected for either research studies
other than the proposed research or nonresearch purposes, when the:
(1) application specifically declares it is
seeking broad consent and contains an adequate description of the broad consent
process; and
(2) proposed research
project satisfies the requirements of Title
45 C.F.R. §
46.116(d).
(c)
Waiver or alteration of
consent. When appropriate, an application for a proposed research study
may seek a waiver from the requirements to obtain informed consent or it may
seek permission to alter the informed consent requirements. Such a waiver or
alteration may be permitted by the DHSIRB when the requirements of
45 C.F.R. §
46.116(e) & (f) are met.
(d)
Informed consent
documentation.
(1)
Use of a
written informed consent form. Except as provided in (3) of this
subsection, informed consent is documented by the use of a written informed
consent form, approved by the DHSIRB and signed, including in an electronic
format, by the subject or the subject's legally authorized representative. A
written copy is given to the person signing the informed consent form.
(2)
Written consent form
options. Except as provided in (3) of this subsection, the informed
consent form may be either (A) or (B).
(A) A
written informed consent form that meets the requirements of this Section. The
investigator gives the subject or the subject's legally authorized
representative adequate opportunity to read the informed consent form before it
is signed; alternatively, this form may be read to the subject or the subject's
legally authorized representative.
(B) A short written consent form stating the
elements of informed consent required by this Section were presented orally to
the subject or the subject's legally authorized representative, and that the
key information required by
45 C.F.R. §
46.116(a)(5)(i) was
presented first to the subject, before other information, if any, was provided.
(i) Informed consent must begin with a
concise, organized, and focused presentation of the key information most likely
to assist a prospective subject or legally authorized representative understand
the reasons why one might, or might not, want to participate in the research.
This portion of the informed consent process must be organized and presented in
a way that facilitates comprehension.
(ii) The DHSIRB approves a written summary of
what is said to the subject or the legally authorized representative. When the
short form method is used, there must be a witness to the verbal presentation.
Only the short form itself is signed by the subject or the subject's legally
authorized representative. The witness signs the short form and a copy of the
summary, and the person obtaining consent signs a summary copy.
(iii) Summary and short form copies are given
to the subject or the subject's legally authorized representative.
(3)
Documentation
waiver requirement.
(A) In certain
defined circumstances, the DHSIRB may waive the requirement for the
investigator to obtain a signed informed consent form for some or all subjects.
(i) The requirement may be waived if the
DHSIRB makes a determination that the only record linking the subject and the
research would be the informed consent form, and the principal risk would be
potential harm resulting from a breach of confidentiality. Each subject or
legally authorized representative is asked if the subject wants documentation
linking the subject with the research. The subject makes the decision.
(ii) The requirement may be waived
if the DHSIRB makes a determination that the research presents no more than
minimal risk of harm to subjects and involves no procedures for which written
consent is normally required outside of the research context.
(iii) The requirement may be waived if the
DHSIRB makes a determination that the subjects or legally authorized
representatives are members of a distinct cultural group or community in which
signing forms is not the norm. The DHSIRB must also determine that the research
presents no more than minimal risk of harm to subjects, and there is an
appropriate alternative mechanism for documenting that informed consent was
obtained.
(B) In cases
in which the documentation requirement is waived, the DHSIRB may require the
investigator to provide subjects or legally authorized representatives with a
written statement regarding the research.