Ethical Issues in Informed Consent: Common Pitfalls and How to Avoid Them

Informed consent is a foundational requirement for ethical research involving human participants. It rests on the principle that individuals have the right to decide freely whether to participate in research after receiving complete and understandable information about what participation involves. This article examines common ethical issues that arise in the informed consent process, including coercion, therapeutic misconception, comprehension challenges, and emerging dilemmas in new research contexts. It provides practical strategies for researchers, students, and life-science professionals to identify and address these issues in their own work.

At a Glance: Common Informed Consent Pitfalls and Mitigation Strategies

The Ethical Foundations of Informed Consent

The requirement for informed consent in biomedical research emerged from historical failures to protect research participants. Contemporary research ethics is guided by four cardinal principles: autonomy, beneficence, nonmaleficence, and justice. These principles were gradually adopted after World War II, primarily in response to the unethical behavior of German physicians and scientists during the Third Reich. Patients and research subjects now have complete autonomy while under medical care or when volunteering as research subjects. Enrolling volunteers in human subjects research includes a detailed and meaningful informed consent process that follows these principles.

The Nuremberg Code and the Declaration of Helsinki established the place of ethics in biomedical research, and the importance of ethics in this field has continued to increase. Researchers must understand that informed consent is also a procedural requirement but a substantive ethical obligation that respects the dignity and self-determination of participants.

Informed consent is both a foundational principle of research ethics and a human right grounded in self-determination and bodily integrity. During the COVID-19 pandemic, legislative attempts were made in South Korea to bypass informed consent and ethics review requirements for research involving patients with infectious diseases. A coalition of civil society actors, including human rights advocates, patient organizations, labor unions, medical professionals, and bioethics scholars, mounted a coordinated public response. Their efforts helped prevent the proposed legislation from advancing in the parliamentary process. This case illustrates how informed consent can function as a hard-won civil right anchored in democratic participation instead of simply a technical requirement.

Core Elements of a Valid Informed Consent Process

A valid informed consent process requires more than a signed form. The process must ensure that participants receive relevant information, understand that information, and make a voluntary decision about participation.

Information Disclosure

Participants must receive information about the purpose of the research, the procedures involved, the expected duration of participation, foreseeable risks and discomforts, potential benefits, alternative procedures or treatments, the extent of confidentiality protections, and the voluntary nature of participation. The information must be presented in language that participants can understand, avoiding technical jargon where possible.

Research protocols should achieve maximum benefits for society, have clinical and scientific value, be subject to independent review, respect human dignity, and follow the principles of informed consent. Most importantly, subjects should have complete autonomy. However, current principles and regulations cannot cover every conceivable situation, particularly in view of new advances in science and technology.

Comprehension

Providing information is not sufficient if participants cannot understand it. Researchers must assess whether participants comprehend the key elements of the study. This is particularly challenging when working with populations that may have cognitive impairments, communication difficulties, or limited health literacy.

Research in aphasia, for example, raises specific ethical issues because the condition itself affects the ability to understand and communicate information. Researchers working with such populations must adapt their consent processes to ensure genuine comprehension instead of assuming that a signed form indicates understanding.

Voluntariness

Participants must make their decision to participate freely, without coercion or undue influence. Coercion can take many forms, including explicit pressure from researchers or clinicians, implicit pressure from power imbalances, or inducements that are so large that they impair judgment. Organizations that conduct research should take steps to minimize the potential for undue influence by ensuring that informed consent discussions will be private and that information about research participation will be kept confidential.

Common Pitfall: Coercion and Undue Influence

Coercion occurs when a person is compelled to participate in research through explicit or implicit threats. Undue influence occurs when an excessive or inappropriate reward or other incentive is offered to obtain compliance. Both undermine the voluntariness that is essential to valid consent.

Sources of Coercion in Research Settings

Power imbalances are a common source of coercion. When researchers are also clinicians, patients may fear that declining to participate will compromise their medical care. Students may feel pressured to participate in research conducted by their professors. Employees may worry about job security if they decline to participate in workplace research.

In humanitarian settings, the risks of coercion are particularly acute. A systematic review of research undertaken during the armed conflict in Darfur between 2004 and 2012 found that only 13.2 percent of eligible studies reported gaining ethical approval and 42.6 percent reported that informed consent was obtained from participants. Among reports archived at the Centre for Research on the Epidemiology of Disasters, none mentioned gaining ethical approval and only 12.3 percent mentioned obtaining informed consent. Populations affected by conflict and displacement may be particularly vulnerable to coercion because of their dependence on humanitarian assistance.

Strategies to Minimize Coercion

Researchers should design consent processes that reduce the potential for coercion. Consent discussions should be conducted in private settings where participants feel free to ask questions and decline participation. Information about research participation should be kept confidential so that decisions do not affect other aspects of participants' lives.

Compensation for participation should be reasonable and should not be so large that it constitutes an inducement. Researchers should clearly communicate that declining to participate will not affect access to medical care, educational opportunities, employment, or other benefits.

Common Pitfall: Therapeutic Misconception

Therapeutic misconception occurs when research participants fail to appreciate the distinction between research and clinical care. Participants may believe that the research intervention is designed primarily for their personal medical benefit, when in fact the primary purpose of research is to generate generalizable knowledge.

How Therapeutic Misconception Undermines Valid Consent

When participants hold a therapeutic misconception, their decision to enroll may be based on a misunderstanding of the study's purpose and potential benefits. They may overestimate the likelihood of personal benefit and underestimate the risks of participation. This undermines the informed nature of their consent.

Therapeutic misconception can be particularly problematic in clinical trials where the research intervention resembles standard medical treatment. Participants may assume that their physician would not recommend participation unless it was in their best medical interest. Researchers must actively work to dispel this misconception.

Strategies to Address Therapeutic Misconception

Researchers should clearly distinguish research procedures from clinical care during the consent discussion. The consent form should explain that the purpose of the study is to answer a scientific question, not to provide personal medical benefit. Researchers should explain the difference between randomization and treatment assignment, the use of placebos or control conditions, and the fact that the research intervention may not be the best available treatment.

Checking participant understanding during the consent discussion is essential. Researchers can ask participants to explain in their own words what they understand about the study purpose, procedures, and potential risks and benefits. This teach-back method can reveal misconceptions that need to be corrected.

Common Pitfall: Comprehension Challenges

Even when researchers provide complete information, participants may not understand it. Comprehension challenges can arise from complex study designs, technical language, cognitive impairments, communication difficulties, or cultural and linguistic differences.

Populations with Specific Comprehension Challenges

Research involving participants with cognitive impairments raises particular concerns about the capacity to consent. In psychiatric research, for example, the nature of the condition being studied may affect participants' ability to understand and appreciate the implications of research participation. Researchers must assess capacity and use appropriate safeguards, which may include simplified consent materials, involvement of family members or advocates, or ongoing assessment of comprehension throughout the study.

Research involving children requires special consideration. Pediatric psychopharmacology research raises informed consent issues that differ from those in adult research. Parents or guardians must provide permission, and children must provide assent when they are capable of doing so. Researchers must balance the need for rigorous research with the obligation to protect vulnerable participants.

Research involving participants with communication impairments, such as aphasia, requires adapted consent processes. Standard consent forms may be inaccessible to individuals who have difficulty processing written or spoken language. Researchers must develop alternative approaches that ensure genuine comprehension.

Strategies to Improve Comprehension

Use plain language in consent materials. Avoid technical jargon and explain complex concepts in terms that a layperson can understand. Provide information in multiple formats, including written materials, verbal explanations, and visual aids where appropriate.

Use teach-back methods to assess comprehension. Ask participants to explain the key elements of the study in their own words. This also assesses comprehension but also reinforces understanding.

Allow adequate time for the consent process. Participants should have the opportunity to ask questions and to take time to consider their decision. Rushing the consent process increases the risk of misunderstanding.

Consider the use of multimedia consent tools. Video presentations and interactive computer-based consent programs can improve comprehension for some populations. However, these tools should supplement, not replace, personal interaction with research staff.

Common Pitfall: Incomplete Disclosure of Risks

Researchers have an obligation to disclose all foreseeable risks of research participation. These risks may be physical, psychological, social, economic, or legal. Incomplete disclosure can occur when researchers minimize risks, fail to anticipate potential harms, or use language that obscures the severity of risks.

Types of Risks That May Be Overlooked

Psychological risks may include anxiety, distress, or discomfort resulting from study procedures or from learning information about oneself. In genetic research, participants may learn information about their risk for future diseases, which can cause psychological distress and have implications for family members.

Social risks may include stigmatization or discrimination. Research on sensitive topics, such as mental health, substance use, or genetic predispositions, may create risks if information is disclosed to employers, insurers, or community members.

Economic risks may include costs associated with participation, such as time away from work or travel expenses. In some cases, participation may affect insurability or employability.

Strategies to Ensure Complete Disclosure

Conduct a thorough risk assessment during study design. Consider all categories of risk, beyond physical risks. Consult with colleagues, ethics committees, and community representatives to identify potential harms that may not be obvious.

Use clear and specific language to describe risks. Avoid vague terms like "minimal risk" without explaining what that means in the context of the specific study. Describe the likelihood and severity of potential harms.

Review consent materials regularly to ensure that they reflect current understanding of risks. As research progresses, new risks may become apparent. Participants should be informed of significant new information that may affect their willingness to continue participation.

Common Pitfall: Consent as a One-Time Event

Informed consent is often treated as a single event that occurs at the beginning of a study. However, ethical consent is an ongoing process. Participants should have the opportunity to reconsider their decision as the study progresses and as new information becomes available.

The Problem with Static Consent

Static consent models assume that the information provided at the beginning of a study remains sufficient throughout the study. This assumption is problematic for several reasons. Studies may evolve in ways that were not anticipated at the outset. New risks may become apparent. Participants' circumstances may change in ways that affect their willingness to continue.

Long-term studies present particular challenges. Participants may forget key elements of the study over time. Their understanding of the risks and benefits may change. Researchers have an obligation to maintain ongoing communication with participants.

Dynamic Consent Models

Dynamic consent models involve periodic re-consent encounters throughout the study. These encounters provide opportunities to update participants on study progress, inform them of new findings, and confirm their continued willingness to participate.

The need for dynamic consent is particularly acute in research involving implantable devices. In some long-term invasive brain-computer interface cases, participants who initially consent to later device explantation may subsequently develop functional dependence on, and phenomenological incorporation of, the device. Post-implantation integration can weaken the continuing moral authority of initial consent to explantation. The distinctive diachronic consent problem arises when ex ante experiential ignorance is combined with extended cognition, embodied agency, functional dependence, and the possibility that explantation would remove a device experienced as part of the user's agential system. Proposed reforms include adopting a dynamic consent model with periodic re-consent encounters and establishing ongoing consent processes.

Strategies for Ongoing Consent

Build re-consent encounters into the study protocol. Schedule regular check-ins with participants to review their understanding and confirm their willingness to continue.

Develop procedures for informing participants of significant new information. This may include new risks, new findings, or changes to the study protocol that affect participants.

Document all consent interactions, beyond the initial consent. Maintain records of re-consent encounters and any changes to participant status.

Common Pitfall: Secondary Use of Data and Biospecimens

Research data and biospecimens are often stored for future use. Participants may not be informed that their data or samples will be used for purposes beyond the original study. This raises questions about the scope of consent and the need for additional consent for secondary uses.

The Scope of Consent

Informed consent given for an original study is not necessarily still valid at the systematic review level. Similarly, consent for one research purpose does not automatically extend to other purposes. Researchers must consider whether participants have consented to the specific uses of their data and samples.

Human population genetics raises novel ethical problems because both the individuals and the populations being studied are subjects of the research. Populations are collectively subject to possible benefits and harms from the research and have interests that must be considered from both ethical and practical standpoints. Researchers must consider whether to obtain the informed consent of both the individual subjects and the group as a collectivity.

De-identification and Anonymization

De-identification and anonymization of data can reduce the ethical concerns associated with secondary use. However, these approaches have limitations. De-identified data may be re-identifiable, particularly when combined with other data sources. Anonymized data may not be truly anonymous.

In individual participant data meta-analyses, there are five ethics items that are inconsistently included in published reports: whether approval from a research ethics committee was obtained for the included trials, whether participants of those trials provided informed consent, whether the meta-analysis itself was approved by a research ethics committee, what the de-identification status was for the data, and whether the participants in all the trials included in the meta-analysis had given their consent or had not objected to the secondary use and sharing of their data with third parties. Readers should be informed about these five items in the text of the meta-analysis or in the disclosure section of the published report.

Strategies for Managing Secondary Use

Disclose planned secondary uses during the initial consent process. If researchers anticipate that data or samples may be used for future research, this should be explained to participants.

Consider whether broad consent is appropriate. Some research contexts may support broad consent for future unspecified research, while others may require specific consent for each use.

Develop clear policies for de-identification and data sharing. Researchers should understand the limitations of de-identification and should implement appropriate safeguards.

Emerging Ethical Issues in New Research Contexts

New research technologies and settings create novel ethical challenges for informed consent. Researchers must anticipate these challenges and develop appropriate responses.

Artificial Intelligence in Clinical Decision-Making

Artificial intelligence integration in oncology is transforming therapeutic decision-making by providing clinical decision support. AI may improve treatment precision, but it raises ethical, legal, and informed consent issues. Key concerns include algorithmic transparency, unclear accountability in AI-guided decisions, data privacy, and gaps in patient understanding of AI's role in their care.

Medical adaptive machine learning systems that continuously update their models using clinical data blur the conventional boundary between therapy and research. Consent-centered ethics faces two structural limitations in this context. First, the irreversibility inherent in deep learning models substantially undermines withdrawability, suggesting that consent may be transformed from an instrument of ongoing self-determination into a form of delegation to institutions. Second, the problem of data representativeness and bias shifts the unit of ethical analysis from the individual to the population, creating an autonomy dilemma in which respect for individual consent can paradoxically undermine the protection of autonomy at the collective level.

Researchers and clinicians must develop robust informed consent models that address the unique challenges of AI. This includes explaining the role of AI in decision-making, addressing algorithmic transparency, and establishing clear accountability.

Space Exploration Research

Applying informed consent principles to space exploration research creates unique challenges and dilemmas. Informed consent for space exploration research should be required, but exceptions can be justified for research involving public records, de-identified medical records, secondary use of de-identified biospecimens or data, emergency medical research, and research critical to mission success or crew safety.

Organizations that conduct space exploration research should take steps to minimize the potential for undue influence. Prospective spaceflight participants should be provided with information about research activities or other types of data and specimen collection that will take place. Since existing laws and regulations do not apply to most of the research activities conducted by private companies, space companies should give serious thought to developing guidelines for the protection of human research participants.

Xenotransplantation

Xenotransplantation raises ethical issues under four headings: interfering with nature, effects on the recipient, effects on other humans, and effects on donor animals. The risks that xenotransplantation carries for the recipient are a matter for properly informed consent. However, if we take seriously the risk of transferring new infectious agents from animal to human populations and the interests of donor animals, then a moratorium on xenotransplantation may be called for.

Genetic Pedigree Research

Genetic pedigree research raises specific informed consent issues at two stages: the construction of tentative pedigrees to determine family eligibility for study and the subsequent enrollment of subjects in and conduct of the family study. Increasing concern to protect the privacy of family members of primary subjects has led some researchers and Institutional Review Boards to apply informed consent requirements to those represented on a tentative pedigree at the initial stage of research.

The likely risk-benefit ratio may favor granting a waiver of consent requirements for the initial stage of pedigree construction. Particular ethical concerns should be addressed in the informed consent discussion when enrolling subjects in pedigree studies, including concerns about subjects' competence to consent, management of interim and incidental findings, and issues particular to psychiatric research.

Practical Implementation: Building an Ethical Consent Process

Researchers can take concrete steps to build ethical consent processes that address common pitfalls.

Step 1: Conduct a Risk Assessment

Before designing the consent process, conduct a thorough assessment of the risks and benefits of the research. Consider physical, psychological, social, economic, and legal risks. Identify the populations that will be recruited and any specific vulnerabilities they may have.

Step 2: Design the Consent Process

Design a consent process that addresses the specific characteristics of the study and the participant population. Consider the following elements:

• Who will conduct the consent discussion
• What information will be provided and in what format
• How comprehension will be assessed
• How voluntariness will be protected
• How ongoing consent will be maintained
• How secondary uses will be disclosed

Step 3: Develop Consent Materials

Develop consent materials that are clear, complete, and accessible. Use plain language. Avoid technical jargon. Provide information in multiple formats where appropriate. Include all required elements of consent.

Step 4: Train Research Staff

Train all research staff who will be involved in the consent process. Ensure that they understand the ethical principles underlying informed consent and the specific requirements of the study protocol. Provide guidance on how to conduct consent discussions, assess comprehension, and respond to participant questions.

Step 5: Implement and Monitor the Consent Process

Implement the consent process according to the protocol. Monitor the process to ensure that it is working as intended. Collect feedback from participants about their experience of the consent process. Use this feedback to make improvements.

Step 6: Document and Audit

Document all consent interactions. Maintain records of consent forms, re-consent encounters, and any issues that arise. Conduct periodic audits of consent documentation to ensure compliance with institutional requirements.

Records and Measurements: What to Track

Researchers should maintain records that allow them to evaluate the quality of their consent processes. Useful records include:

• Consent forms, signed and dated
• Documentation of consent discussions, including who conducted them and what topics were covered
• Records of re-consent encounters
• Documentation of any comprehension assessments
• Records of participant questions and how they were addressed
• Documentation of any incidents or concerns related to the consent process
• Feedback from participants about their experience of the consent process

These records serve multiple purposes. They demonstrate compliance with ethical and regulatory requirements. They provide evidence that the consent process was conducted properly. They support quality improvement efforts by identifying areas where the process can be improved.

Common Failure Patterns in Consent Processes

Researchers should be alert to common failure patterns that indicate problems with the consent process.

Pattern 1: Consent Forms That Are Too Long or Too Complex

Consent forms that are excessively long or written at a high reading level are unlikely to be understood by participants. If participants cannot understand the consent form, their consent is not truly informed. Researchers should review consent forms regularly to ensure that they are accessible.

Pattern 2: Consent as a Formality

When consent is treated as a formality, the consent discussion may be rushed or skipped entirely. Participants may be asked to sign a form without having the opportunity to ask questions or fully understand what they are agreeing to. This pattern undermines the ethical foundation of consent.

Pattern 3: Inadequate Attention to Vulnerable Populations

Researchers may fail to adapt their consent processes to the needs of vulnerable populations. This can result in participants who do not understand the research or who are unable to make a truly voluntary decision. Researchers must identify vulnerable populations and develop appropriate safeguards.

Pattern 4: Failure to Maintain Ongoing Consent

Researchers may treat consent as a one-time event and fail to maintain ongoing communication with participants. This can result in participants who continue in a study without understanding current risks or who are not informed of new information that might affect their willingness to continue.

Pattern 5: Incomplete Documentation

Researchers may fail to document consent interactions properly. This can create problems if questions arise about whether consent was obtained or whether participants were fully informed. Incomplete documentation also undermines the ability to audit and improve consent processes.

Limitations of Informed Consent

Informed consent is an essential ethical requirement, but it has limitations that researchers should recognize.

Consent Cannot Address All Ethical Issues

Informed consent is necessary but not sufficient for ethical research. Some ethical issues cannot be resolved through consent alone. For example, research that poses risks to populations or communities may require consideration of collective interests that go beyond individual consent.

Consent May Be Insufficient in Complex Contexts

In some research contexts, the complexity of the research makes it difficult for participants to understand what they are consenting to. This is particularly true for research involving artificial intelligence, where the algorithms may be opaque even to experts. In such cases, consent may become a form of delegation to institutions instead of an exercise of ongoing self-determination.

Consent Does Not Eliminate the Need for Ethical Oversight

Informed consent does not replace the need for independent ethical review. Research protocols should be subject to independent review by ethics committees. This review provides an additional layer of protection for research participants.

Ethical Issues Change Over Time and Location

Ethical issues change so much with time and location, and are so broad in scope and in context that it appears illusory to search for a universal, internationally accepted standard for ethical assessment. Researchers must be attentive to the specific ethical context of their research and must be prepared to adapt their practices accordingly.

Professional Escalation Criteria

Researchers should know when to escalate concerns about informed consent to appropriate authorities. Escalation is appropriate in the following circumstances:

• When there is evidence that participants have been coerced or unduly influenced
• When there is evidence that participants have not been fully informed about the research
• When there is evidence that the consent process has been conducted improperly
• When there are concerns about the capacity of participants to consent
• When there are concerns about the adequacy of consent documentation
• When there are questions about whether consent obtained for one purpose can be used for another purpose

In these circumstances, researchers should consult with their institutional review board or ethics committee. In some cases, it may be necessary to suspend research activities until the concerns are resolved.

Frequently Asked Questions

What is the difference between coercion and undue influence in informed consent?

Coercion involves explicit or implicit threats that compel a person to participate in research against their will. Undue influence occurs when an excessive or inappropriate reward or other incentive is offered to obtain compliance. Both undermine the voluntariness that is essential to valid consent. Coercion may involve threats of harm, while undue influence typically involves offers of excessive benefits. Researchers must design consent processes that minimize both.

How can researchers assess whether participants truly understand the research?

Researchers can use teach-back methods, asking participants to explain the key elements of the study in their own words. This approach assesses comprehension and reinforces understanding. Researchers can also use structured comprehension assessments, which may include questions about the study purpose, procedures, risks, and the voluntary nature of participation. The assessment should be appropriate to the participant population and should be conducted in a way that does not pressure participants.

What should researchers do when a participant's capacity to consent is in question?

When there are concerns about a participant's capacity to consent, researchers should assess capacity using appropriate tools and procedures. If capacity is impaired, researchers may need to involve legally authorized representatives, use simplified consent materials, or implement ongoing assessment of comprehension throughout the study. The specific approach will depend on the nature of the impairment and the requirements of applicable regulations.

How should researchers handle consent for secondary use of data and biospecimens?

Researchers should disclose planned secondary uses during the initial consent process. If researchers anticipate that data or samples may be used for future research, this should be explained to participants. Researchers should consider whether broad consent is appropriate or whether specific consent is required for each use. De-identification and anonymization can reduce ethical concerns, but these approaches have limitations.

What is therapeutic misconception and why does it matter?

Therapeutic misconception occurs when research participants fail to appreciate the distinction between research and clinical care. Participants may believe that the research intervention is designed primarily for their personal medical benefit, when in fact the primary purpose of research is to generate generalizable knowledge. This undermines the informed nature of consent because participants may overestimate the likelihood of personal benefit and underestimate the risks of participation.

How can researchers minimize the potential for undue influence in research participation?

Researchers can minimize the potential for undue influence by ensuring that informed consent discussions are private, keeping information about research participation confidential, and keeping compensation at levels that do not constitute inducement. Researchers should clearly communicate that declining to participate will not affect access to medical care, educational opportunities, employment, or other benefits.

What are the ethical issues in systematic reviews related to informed consent?

Systematic reviews may contain studies with ethical insufficiencies, may be a possible way to publish unethical research, and may be prone to conflict of interest. Informed consent given for an original study is not necessarily still valid at the systematic review level. Routine ethical assessment in systematic reviews would help to improve the ethical and methodological quality of studies in general.

How should consent processes be adapted for research in humanitarian or conflict settings?

Research in humanitarian settings requires particular attention to the potential for coercion. Populations affected by conflict and displacement may be particularly vulnerable because of their dependence on humanitarian assistance. Researchers should ensure that consent discussions are private, that participation decisions do not affect access to assistance, and that participants understand the research purpose and their rights. Ethical review and informed consent should be documented and reported.

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References and Further Reading

• Research Data Framework. National Institute of Standards and Technology.
• EQUATOR Network. EQUATOR Network.
• Experimental Design Assistant. NC3Rs.
• NCBI Literature Resources. National Center for Biotechnology Information.
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• Ethical issues in bipolar disorders pedigree research: privacy concerns, informed consent, and grounds for waiver.. Bipolar disorders, 2002.
• Informed consent and other ethical issues in human population genetics.. Annual review of genetics, 2001.
• Xenografting: ethical issues.. Journal of medical ethics, 1998.
• Ethical issues in research.. Best practice & research. Clinical obstetrics & gynaecology, 2017.
• Informed Consent for Research Participation During Space Exploration: Ethical Issues.. Bioethics, 2026.
• Mention of ethical review and informed consent in the reports of research undertaken during the armed conflict in Darfur (2004-2012): a systematic review.. BMC medical ethics, 2019.
• Participant observation, informed consent and ethical approval.. Nurse researcher, 2002.
• Consent in flux: when brain-computer interface embodiment undermines informed consent.. 2026.
• Defending Informed Consent: Civil Society's Victory Against Emergency Research Deregulation in South Korea.. 2026.
• Inconsistent ethics reporting in individual participant data meta-analyses: a call for updating PRISMA and PRISMA-IPD.. 2026.
• Beyond consent: Reconstructing ethical justification in medical adaptive machine learning systems.. 2026.
• Correction: Tango-therapy vs physical exercise in older people with dementia, a randomized controlled trial.. 2026.
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• Artificial Intelligence and Decision-Making in Oncology: A Review of Ethical, Legal, and Informed Consent Challenges. Current Oncology Reports, 2025.
• Research Guides: Immortal Life of Henrietta Lacks: Informed Consent/Ethical Issues. 2012.
• Ethical issues and considerations involved in informed consent for ART therapy. Chinese Journal of Reproduction and Contraception, 2025.
• Informed consent as an ethical issue in modern optometry.. Journal of the American Optometric Association, 1994.

This article is educational and does not replace institutional policy, professional advice, or applicable safety and regulatory requirements.