Survey finds seven in ten hospitals violate DHEW Guidelines on informed consent for sterilization.
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This paper evaluates the public hearing process and discusses some implications and ramifications of a public hearing process within one health systems agency (HSA). Standards for a public hearing are outlined. The standards include the utilization of logic and simple language in the preparation of the proposal, the delineation of public consent and public opinion, clarification of the intent of the public hearing, the preparation of the public for the hearing, and the post-hearing work program. This evaluative study indicates that the public hearing process had minimal direct effect on the HSP and AIP but substantial indirect effects. Indirect effects included influencing the content and issues, defining linkages, delineation of public consent and public opinion, and heightening a sense of political feasibility and public credibility. Equally important was the staff awareness of the political-social climate of the region, the governing board and the DHEW Guidelines. Recommendations for HSAs are also developed. These include the development of a responsive mechanism, the "stimulation" of proponents, education on the nature of the public hearing process, and clarification of the nature of the public interest.
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A series of experiments on environmental noise was performed over a 3-year period. Those experiments in the series that incorporated federal subjects guidelines concerning informed consent failed to replicate the negative aftereffects of noise found earlier by Glass and Singer. The experiments that were performed before implementation of the federal guidelines, however, successfully replicated the Glass and Singer findings. To clarify this pattern of results, a final experiment was performed on two groups of subjects treated identically except that one group gave informed consent while the other did not. The results confirmed that the subject procedures involving informed consent as defined by the federal guidelines prevent the emergence of negative aftereffects of noise, possibly because these procedures give the subjects what amounts to control over the stressor. Similar phenomena may occur in research on other environmental stressors, such as crowding and electric shock, in which subject's perception of control is a critical variable. Possible techniques for performing future research of this type are discussed.
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