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Studies can be conducted without obtaining informed consent (or parental consent) or using a consent process that includes altered elements but only if the HSRO grants a waiver of the informed consent requirement. In order for an IRB to waive or alter consent, the IRB must find and document all of the following points: * This new criterion is that the IRB must determine that the research could not practicably be carried out without using the information or biospecimens in an identifiable form. The purpose of this additional criterion is that if the research could be done using non-identifiable
information, then that is what should be done. In these cases, researchers shouldn’t be using identifiable information because it increases the risk of breaches of privacy or confidentiality. In each case, all of the points must be evident for a waiver. The IRB will consider whether a waiver is appropriate and may not grant one if they feel it is not in the best interest of the subjects. Sometimes, particularly in behavioral research, investigators plan to withhold information about
the real purpose of the research or even give subjects false information about some aspect of the research. This means that the subject's consent may not be fully informed. When the IRB reviews research involving incomplete disclosure or outright deception it must decide whether the information to be withheld would influence the decision of prospective subjects about participating in the research. The IRB will consider the risks to which subjects will be exposed and then decide
whether to waive or alter consent requirements. To receive a waiver of consent requirements, the study must present no more than minimal risk and the waiver must not adversely affect the rights and welfare of subjects, and must be essential to the ability to carry out the research. Whenever appropriate, subjects should be given additional pertinent information after they have participated in such a study. The IRB will determine if a debriefing form is necessary and will guide the
Investigator in what information should be disclosed. AddtoAny Frequently called Verbal Consent, the process is more correctly referred to as Informed Consent with Waiver of Documentation. The investigator must obtain consent following the same requirements as written
consent but the subject does not sign a consent form. Waiver of documentation of consent is permitted under a limited set of circumstances. The first requirement is that the research is not greater than minimal. This process is sometimes referred to as verbal consent. To waiver documentation of consent, the research must meet the regulatory criteria of
45 CFR 46.117(c) or 21 CFR 50.109(c). §46.117(c): (i) 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) will be asked whether the subject wants documentation linking the subject with the research, and the subject's wishes will govern; (ii) 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; or Note: This is equivalent to
§56.109(c)(1). (iii) If the subjects or legally authorized representatives are members of a distinct cultural group or community in which signing forms is not the norm, that the research presents no more than minimal risk of harm to subjects and provided there is an appropriate alternative mechanism for documenting that informed consent was obtained. When a waiver of documentation of informed consent is issued by the IRB the consent process needs to adhere to all of the requirements of consent. In addition, if the study is subject to HIPAA, written HIPAA authorization may still be required unless the study also qualifies for alteration of the requirement for written HIPAA Authorization. The IRB's preference is for the investigator to create consent document using the usual consent template but with a substitution for the usual signature page with one that allows the investigator to document the subject's verbal consent. Examples of situations and options for verbal consent are included below:
This option most often applies to surveys and questionnaires but can also include a specimen collection kit. The questionnaire or specimen collection kit should be accompanied by a letter, webpage or consent form inviting the individual to participate. The letter, webpage instructions or consent form should include:
This process is sometimes referred to as implied consent, which is not a term recognized by OHRP. They would consider this to be informed consent with waiver of documentation (provided the IRB has waived documentation under 45 CFR 46.117(c)(1)(i), (ii) or (iii)). See OHRP for a discussion about implied consent. Depending on the circumstances, it may still be appropriate to document that the consent process took place. Waiver under 45CFR46.117(c)(1)(i)
Waiver under 45CFR46.117(c)(1)(ii)
If the plan is to document consent on a copy of the consent form, substitute signature blocks are available in the Special Signatures Page section of the Consent Form Templates page. Waiver under 45CFR46.117(c)(1)(iii)
If the plan is to document consent on a copy of the consent form, substitute signature blocks are available in the Special Signatures Page section of the Consent Form Templates page. Please note that these criteria require that an appropriate alternative method is available for documenting that informed consent was obtained. Example Signature Page to Document Consent Process:Audio or Videotaping a Verbal ConsentAlthough audio and videotaping are considered to be minimal risk procedures, CHOP Policy "Recording or Filming of Patients" requires written consent when CHOP patients are involved. Since the requirements of 45 CFR 46.117(c)(1)(ii) specify that a waiver can be granted when the research "involves no procedures for which written consent is normally required outside of the research context" audiotaping and videotaping do not generally qualify. If the participants do not meet the definition of a CHOP patient as defined in the CHOP policy then written consent is not required. This could include physicians and nurses at CHOP or parents of patients. CHOP legal counsel has concluded that if the consent process for a CHOP patient/subject is taped and then retained as evidence of the consent, then this recording will meet CHOP's requirement for documentation of consent. Under this circumstance, the IRB may waive the requirement for written consent. The details of the requirements are included below and in an email outlining the requirements from CHOP legal counsel. When can the IRB waive the requirement for written consent for audiotaping for patient-subjects? If the subject is physically present and is a patient at CHOP, the IRB cannot waive the requirement. This effectively eliminates waivers for videotaping of patient-subjects. If the research involves a telephone interview, then the IRB will consider a request for a waiver. The investigator must do the following:
Waiver of Documentation of HIPAA Authorization45 CFR 164.164.512: When the research qualifies for a Waiver or Alteration of HIPAA under 45 CFR 164.512(i)(2)(ii) then "A covered entity may use or disclose protected health information without the written authorization of the individual, as described in §164.508, or the opportunity for the individual to agree or object as described in 164.510, in the situations covered by this section, subject to the applicable requirements of this section. When the covered entity is required by this section to inform the individual of, or when the individual may agree to, a use or disclosure permitted by this section, the covered entity's information and the individual's agreement may be given orally." Frequently Asked Questions
When can informed consent be waived?Waiver of Documentation of Informed Consent (45 CFR 46.117)
A waiver of documentation is permissible when: The signature on the informed consent document would be the only record linking the subject to the research and the principal risk of harm to the subject would be a breach of confidentiality.
What is a waiver of documentation of informed consent?A waiver of documentation of informed consent is a request whereby a signed consent document is not required. Examples include online, verbal, and implied consent. Consent will still be obtained from participants; however, they will not be required to sign the consent form.
Can the requirement for informed consent be waived quizlet?The requirement to document informed consent can be waived if the only record linking the subject and the research is the consent document and the principal risk is a breach of confidentiality.
What is a waiver of requirement?verb. If you waive your right to something, for example legal representation, you choose not to have it or do it.
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