Question

What are some constraints on voluntariness in informed consent? Can they be avoided? Can anyone truly make a decision completely free of influence? Why or why not? Where do you draw the line between acceptable and unacceptable forms of influence?

Answer 1

Ans) Some maintain that voluntariness is a value-neutral concept. On that view, someone acts involuntarily if subject to a controlling influence or has no acceptable alternatives.

- I argue that a value-neutral conception of voluntariness cannot explain when and why consent is invalid and that we need a moralized account of voluntariness. On that view, most concerns about the voluntariness of consent to participate in research are not well founded.

- The principal theoretical aim of this paper is not to resolve the question as to whether consent is voluntary and valid in one case or another but to argue that no value-neutral theory of voluntariness is going to answer such a question.

- If we adopt a value-neutral account of voluntariness along the lines of “no acceptable alternative” or “controlling influence,” then we will be forced to abandon the validity requires voluntariness principle and will have to determine whether and when we should regard involuntary consent as valid.

- We can retain our allegiance to the validity requires voluntariness principle by adopting a moralized account of voluntariness in which the voluntariness of a subject’s consent turns on the legitimacy of the means by which her consent is solicited.

- Either way, the question as to whether we should regard consent as valid will turn on moral analysis.

- It may be argued, however, that my moralized account of involuntariness involves a form of circularity. On the standard picture, an involuntariness claim supports a moral claim about the validity of B’s consent. On a moralized account, we effectively use a moral judgment as to whether B’s consent should be regarded as valid to determine we should accept an involuntariness claim.

- And so, it seems that a moralized account of voluntariness involves a form of circularity: (1) If consent is involuntary, then consent is invalid; (2) If consent should be valid, then consent is not involuntary.

- The argument is not strictly circular because involuntariness requires involuntarinessdescriptive is a necessary but not sufficient condition of involuntariness consent. Still, the circularity objection is partly correct. But I don’t think that this circularity can be avoided. At the end of the day, the determination as to whether B’s consent should be regarded as invalid is a moral question to be resolved by moral argument and cannot be resolved by appeal to a value-neutral account of voluntariness.