Law and ethics are two disciplines which are intimately linked. The divergence between them causes conflict in the medical research setting. This can lead to frustration among clinicians who are aiming to provide the best options to their patients and improve care. In Western Australia (WA) there is a current conflict in medical research caused by a lack of support within the Guardianship and Administration Act 1990 (WA) to rely on next-of-kin consent for research.
Medical research ethics in Australia is based on the Principles Based Framework developed by Beauchamp and Childress. This approach requires the balancing of various ethical principles including autonomy and justice. It highlights the value of informed consent and individual autonomy. However, it stresses that autonomy must be balanced against access to research benefits and promoting benefit for vulnerable patients.
In Western Australia there is a strong appetite to conduct research in contexts where the participant may lack the capacity to consent. This includes research in dementia, the ICU, emergency setting, stroke patients and mental health. However, current legislation in WA does not allow for research to be conducted without informed consent of the participant themselves as there is no legislative support for next-of-kin consent to research. This means that within the public health setting no research is being conducted in populations with impaired capacity to consent. This paper explores this conflict in WA and highlights concerns with this risk-averse interpretation of state legislation.