title: Discordance in informed consent response on the basis of demographic factors: brief report.
abstract: During an outcomes study of spasticity treatment at a developmental center for 62 residents with profound intellectual disabilities, either botulinum toxin A (BTX-A), intrathecal baclofen (ITB), or both were recommended with physical and occupational therapy. Conservators consented to BTX-A more than ITB (p = .021). Court-appointed conservators were more likely to provide consent for treatment than family members (p = .026). Nonparents consented more than parents (p = .009). Finally, Caucasian conservators were more likely to consent to treatment than African American conservators (p = .036), but ethnicity of the resident did not influence consent. Gender of resident or conservator did not influence rate of consent. This report highlights disparities in surrogate consent giving for individuals with intellectual disabilities and indicates a need for more research to ensure that this vulnerable population has access to appropriate treatments.
authors.affiliation: Department of Neurology, Baylor College of Medicine, Houston, TX 77030, USA.
authors.forename: Karen R
authors.initials: KR
authors.lastname: Nunez-Wallace
authors.forename: Chandler E
authors.initials: CE
authors.lastname: Gill
authors.forename: Courtney H
authors.initials: CH
authors.lastname: Harrison
authors.forename: Henry M
authors.initials: HM
authors.lastname: Taylor
authors.forename: P David
authors.initials: PD
authors.lastname: Charles
mesh_terms: D001741:Black or African American; D001418:Baclofen / Q000008:administration & dosage*; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage*; D017028:Caregivers / Q000331:legislation & jurisprudence*; D005260:Female; D006801:Humans; D007258:Informed Consent / Q000331:legislation & jurisprudence*; D007273:Injections, Intramuscular; D007278:Injections, Spinal; D008607:Intellectual Disability / Q000208:ethnology / Q000534:rehabilitation*; D007872:Legal Guardians / Q000331:legislation & jurisprudence*; D008297:Male; D009125:Muscle Relaxants, Central / Q000008:administration & dosage*; D009128:Muscle Spasticity / Q000208:ethnology / Q000534:rehabilitation*; D009788:Occupational Therapy; D010290:Parents; D026741:Physical Therapy Modalities; D012112:Residential Facilities; D012959:Socioeconomic Factors; D044465:White People
chemical_list: D009125:Muscle Relaxants, Central; D019274:Botulinum Toxins, Type A; D001418:Baclofen