Protestant perspectives on informed consent (particularly in research involving human participants).

INTRODUCTION It is virtually impossible to state the Protestant position on any bioethical problem or issue. As a result, interpreters must focus on one Protestant position or, at most, identify a few Protestant positions with respect to a particular bioethical problem. Thus, in addressing my assigned topic, I will focus on selected Protestant perspectives on informed consent/refusal, particularly in the context of research involving human subjects or participants. Several factors contribute to this limitation, not the least of which is that a couple of hundred denominations in the United States march under the banner of Protestantism. (1) Even if we start with the major Reformation traditions, we discover that the Lutheran and Calvinist (Reformed) traditions have splintered, (2) and that the so-called "radical" Reformation, or "left-wing" of the Reformation, encompasses numerous other groups, including the Anabaptists, a label that also covers different denominations. (3) An attempt to discern a broad Protestant tradition, in contrast to traditions, would necessarily operate at a very high and largely uninformative level of generality. For example, Paul Tillich identified what he called "the Protestant principle," which represents "the divine and human protest against any absolute claim made for a relative reality, even if this claim is made by a Protestant church." (4) For Tillich, this principle is "the theological expression of the true relation between the unconditional and the conditioned or, religiously speaking, between God and man." (5) It is "the guardian against the attempts of the finite and conditioned to usurp the place of the unconditional in thinking and acting." (6) However important this principle is, it provides little guidance about Protestant beliefs and practices, including bioethics. Yet another limitation is also worth noting. The assigned topic of informed consent, with particular attention to research involving human subjects or participants, has not received extensive treatment in Protestant denominational statements and guidance. To illustrate, I will draw examples from the valuable Park Ridge Center series on different religious traditions' beliefs and practices regarding health care. The document on the Lutheran tradition notes that "consistent with their general respect for medicine and informed decision making, [Lutherans] are likely to favor self-determination and informed consent." (7) The document on the Presbyterian tradition (out of the Calvinist or Reformed tradition) notes that, because of the emphasis on freedom of conscience, Presbyterians would emphasize free exchange of information by patient and caregiver and would tend to err on the side of patient autonomy rather than caregiver paternalism. Turning to research involving human subjects, the document notes that the Presbyterian Church (U.S.A.) "generally supports self-determination and informed consent in medical procedures and experimentation. The General Assembly advocates that `human subjects be given the strongest human protections, including full information about the research, and that their consent be obtained without coercion.'" (8) The Park Ridge Center report on Anabaptist beliefs and practices--including the Mennonites and Amish--notes that no official positions were found on therapeutic or nontherapeutic medical experimentation on various populations or on self-determination and informed consent, but, the report continues, the Anabaptist tradition's theological-ethical beliefs, such as God's creation of persons in his own image and noncoercion in religious matters, tend to support self-determination and informed consent in such settings. (9) The report on the United Methodist tradition stresses that, for Methodists, personal autonomy and self-determination are highly valued because God has created human beings in his own image. …