Informed consent to opioid agonist maintenance treatment: Recommended ethical guidelines
International Journal of Drug PolicyPublished 1 February 2008
Adrian Carter, Wayne Hall
Citations32
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SJR score1.48
SNIP1.36
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TL;DR
An ethical analysis of the competing social and medical forces that influence the consent process is provided and some recommendations on how to ensure that individuals enter maintenance treatment that is provided in an effective and ethical way are made.
Abstract
Informed consent is an important part of the treatment process that should be obtained in ways that increase the autonomy and decision-making capacity in opioid addicts.
Keywords
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