Evaluation Summary for Quantitative Lit.: RQLT Task 4 Final Score: Does not Meet Overall comments: A two-column was provided in the submission and reflected generally appropriate mathematical logic. Some revisions are needed to ensure that the steps in the proof adequately lead to the statement being proven. Detailed Results (Rubric used: RQLT Task 4) Articulation of Response (clarity, organization, mechanics)  (0) Unsatisfactory (1) Needs Revision (2) Satisfactory The candidate provides unsatisfactory articulation of response.  The candidate provides weak articulation of response.  The candidate provides adequate articulation of response.  Criterion Score: 2.00  A. Proof  (0) Unsatisfactory (1) Needs Revision (2) Satisfactory The candidate does not accurately complete the appropriate proof using a 2-column proof format with statements on the left and reasons on the right.  The candidate accurately completes all but 1 to 2 steps of the appropriate proof using a 2-column proof format with statements on the left and reasons on the right.  The candidate accurately completes the appropriate proof using a 2-column proof format with statements on the left and reasons on the right.  Criterion Score: 1.00  Comments on this criterion: The submission included a two-column proof that was on the right track to show that triangle DGF is isosceles. The use of ASA was appropriate. Revisions are needed, though, to determine if some of the steps were necessary (e.g., steps 3 through 6) as well as to make sure that the supporting reasons are adequate (e.g., steps 2, 7, 9, and 10). B. Sources  (0) Unsatisfactory (1) Needs Revision (2) Satisfactory When the candidate uses sources, the candidate does not provide in-text citations and/or references for each source used.  When the candidate uses sources, the candidate provides appropriate in-text citations and/or references with major deviations from APA style.  When the candidate uses sources, the candidate provides appropriate in-text citations and/or references accurately or with only minor deviations from APA style, OR the candidate does not use sources.  Criterion Score: 2.00  Comments on this criterion: No sources were cited. Last Name 8 Name Instructor Course 20 May 2013 Rebecca Skloot’s Obtained Consent in Medical Research and ‘Free Choice’ Consent Each year in the United States, around 2.3 million patients sign consent forms in order to participate in government and industry-sponsored clinical trials, with many more participating in research at academic health centers and hospitals (Cohn & Larson 273). The Federal Policy for the Protection of Human Subjects, also known as the Common Rule, requires informed consent for all human-subject research. But, in reality, this does not happen because a huge number of tissue research are not federally funded, and the research is also never considered research on humans since researchers never get to meet donors firsthand (Skloot 231). Henrietta Lacks gifted ...

1. Evaluation Summary for Quantitative Lit.: RQLT Task 4
Final Score:
Does not Meet
Overall comments:
A two-column was provided in the submission and reflected
generally appropriate mathematical logic. Some revisions are
needed to ensure that the steps in the proof adequately lead to
the statement being proven.
Detailed Results (Rubric used: RQLT Task 4)
Articulation of Response (clarity, organization, mechanics)
(0) Unsatisfactory
(1) Needs Revision
(2) Satisfactory
The candidate provides unsatisfactory articulation of response.
The candidate provides weak articulation of response.
The candidate provides adequate articulation of response.
Criterion Score: 2.00
A. Proof
(0) Unsatisfactory
(1) Needs Revision
(2) Satisfactory
The candidate does not accurately complete the appropriate
proof using a 2-column proof format with statements on the left
and reasons on the right.
The candidate accurately completes all but 1 to 2 steps of the
appropriate proof using a 2-column proof format with
statements on the left and reasons on the right.
The candidate accurately completes the appropriate proof using
a 2-column proof format with statements on the left and reasons
on the right.
Criterion Score: 1.00
Comments on this criterion: The submission included a two-
column proof that was on the right track to show that triangle

2. DGF is isosceles. The use of ASA was appropriate. Revisions
are needed, though, to determine if some of the steps were
necessary (e.g., steps 3 through 6) as well as to make sure that
the supporting reasons are adequate (e.g., steps 2, 7, 9, and 10).
B. Sources
(0) Unsatisfactory
(1) Needs Revision
(2) Satisfactory
When the candidate uses sources, the candidate does not provide
in-text citations and/or references for each source used.
When the candidate uses sources, the candidate provides
appropriate in-text citations and/or references with major
deviations from APA style.
When the candidate uses sources, the candidate provides
appropriate in-text citations and/or references accurately or with
only minor deviations from APA style, OR the candidate does
not use sources.
Criterion Score: 2.00
Comments on this criterion: No sources were cited.
Last Name 8
Name
Instructor
Course
20 May 2013
Rebecca Skloot’s Obtained Consent in Medical Research and
‘Free Choice’ Consent
Each year in the United States, around 2.3 million patients sign
consent forms in order to participate in government and

3. industry-sponsored clinical trials, with many more participating
in research at academic health centers and hospitals (Cohn &
Larson 273). The Federal Policy for the Protection of Human
Subjects, also known as the Common Rule, requires informed
consent for all human-subject research. But, in reality, this does
not happen because a huge number of tissue research are not
federally funded, and the research is also never considered
research on humans since researchers never get to meet donors
firsthand (Skloot 231). Henrietta Lacks gifted the world the first
ever immortal human cells, yet she never gave consent to have
her cells removed and used for research, and neither did she
benefit from the widespread use of the unique cells. Today,
consent is necessary in order for personal data to be used in
medical research, unless a person is dead, or researchers are all
healthcare professional or the data collected do not identify the
person (Singleton & Wadsworth 255). However, consent in
medical research though important, should not be equated to
giving a choice to a potential research subject or tissue donor
because consent is simply the carrying out of formalities meant
to protect researchers and adhere to laws governing medical
research and clinical trials. Therefore, although obtained
consent is crucial in medical research, it is not a one fit all
solution; emphasis should be to support free choice among
patients, potential donors and subjects, rather than simply fulfill
the formalities of obtaining consent.
In their research paper Confidentiality and Consent in Medical
Research: Consent for the use of Personal Medical Data in
Research Peter Singleton and Michael Wadsworth define
consent as “. . . a person's expression of agreement with a
proposed action” (256). Thus, in gaining consent, a person does
not willfully make a choice to the course of action; rather they
are guided and directed towards the choice. In fact, Singleton
and Wadsworth observe that even the manner in which a person
is approached influences their decision, meaning that the
‘consent’ gained though indicating agreement with the choices
offered is not really a choice made freely. Singleton and

4. Wadsworth, in arguing for the need for choice, state that
consent implies “. . . compliance rather than consent—a lack of
objection rather than a positive choice” (256). Therefore, when
a patient complies with a request made by a doctor or medical
professional, they do agree with them, but it does not
necessarily mean that the choice to do so is positive, or it is a
decision made willfully. Therefore, informed consent is not
similar to free choice, and this is what medical research ought
to promote, because in doing so, fundamental
misunderstandings in the use, of tissue or medical findings from
patients may not cause heartache to subjects and their families.
Henrietta Lacks’ cells were first introduced to the world when
she went to hospital to get treatment for cancer. Before the
surgery, Henrietta had ‘given consent’ to doctors at Johns
Hopkins Hospital, “. . . to perform any operative procedures and
under any anaesthetic either local or general that they may deem
necessary in the proper surgical care and treatment of cervical
cancer” (27). Thus, the consent that Henrietta had given was the
treatment of cervical cancer. However, even after “. . . two
dime-sized pieces of tissue” were removed from Henrietta’s
cervix, she was not informed, yet she was alive. When the same
pieces of tissue were found to be valuable to medical research,
by virtue of being the first ever immortal human cells, neither
Henrietta nor her family was informed of this feat, yet the same
cells were distributed to scientists all over the world. In fact,
when it was found that the cells proliferated at an amazing rate,
and they could not run out, they were sold to scientists “. . . for
ten dollars plus Air Express fees” (Skloot 73). Thus, when
consent was given by Henrietta Lacks to her doctors to get
treated for cervical cancer, she complied rather than gave
consent. She did not object, but the act of signing was also not a
positive choice, she was guided into signing the consent form,
because in order for her to get treated by undergoing surgery,
she had to sign the consent form.
Apart from the guiding and directing nature that informed
consent adopts, it is also a premise that often takes the

5. assumption that adequate information has been offered, and thus
subjects can make informed choices by giving consent. This
implies that all relevant information has been offered and
therefore the consent given is based on understanding this
information. However, this approach has a fallacy because
individuals have different definitions of how much information
is adequate. In the past, compliance including the retention of
tissue has often been presumed and is the reason information is
not usually offered, meaning that questions cannot be asked to
agree with or dissent to such a decision (Singleton &
Wadsworth 256). Thus, in such a case, it would be assumed that
consent was gained, with such an action, but in reality this is
not so because choice was not offered and adequate information
was not availed. Onora O'Neill in the paper Some Limits of
Informed Consent argues that genuine consent can only be
possible if tissue donor, research subjects and patients are
offered “. . . accurate and relevant information and providing
user friendly ways for them to extend this amount . . . consent is
apparent where patients can control the amount of information
they receive, and what they allow to be done” (6). This implies
that since information can be wide and this can hamper
understanding by subjects, then it should be offered in such a
manner as to ensure that subjects are able to understand it
easily, and also have the ability to control it. Thus, in order for
subjects, patients and tissue donors to have free choice in
informed consent, they should be free to “. . . determine how far
they will be informed, and. . . remain free to rescind their initial
choice. Where these standards are met, there are reasonable
assurances that nobody is coerced or deceived” (O'Neill 6).
Thus, free choice equals adequate information, based on the
subject, tissue donor or patient’s understanding and not the
medical professional who dispenses information quickly in
order to gain consent, devoid of free choice.
When Henrietta Lacks started getting treatment for cervical
cancer, she hoped that one day she would be able to get back to
her family and possible have more children. However, what she

6. was not informed was that the treatment that involved radiation
would leave her infertile. In fact, Skloot points out that had
Henrietta been offered adequate information when she gave
consent for treatment, “. . . she would not have gone through
with treatment” (38). Thus, Henrietta was denied the choice to
make an informed decision based on all facts. However, it could
be argued that by giving consent to get treated for cervical
cancer, then it was implied that Henrietta had agreed to all
effects therein. But this argument does not wash since Telinde,
a doctor at Johns Hopkins, where Henrietta got treated for
cancer had written extensively on the effect of hysterectomy on
women. He stated:
The psychic effect of hysterectomy, especially on the young, is
considerable, and it should not be done without a thorough
understanding on the part of the patient [who is] entitled to a
simple explanation of the facts [including] loss of the
reproductive function. … It is well to present the facts to such
an individual and give her ample time to digest them (Skloot
38).
Thus, Rebecca Skloot shows that informed consent in this case
was not genuine. It was not based on free choice, because the
information provided was not adequate, and thus the patient was
guided and she simply complied with the condition of getting
treatment for her illness, which meant ‘giving consent’ devoid
of free choice and will.
Finally, today informed consent is often seen as the key to
respecting patient autonomy. O'Neill in Some limits of Informed
Consent points out that informed consent is a premise that is
highly esteemed because it is equated to:
Liberty (positive or negative) . . . dignity, integrity,
individuality, independence, responsibility and self knowledge .
. . self assertion . . . critical reflection . . . freedom from
obligation . . . absence of external causation . . . and
knowledge of one's own interests (5).

7. However, the truth is that informed consent is above and beyond
patient autonomy, it is an act that is carried out in the medical
world to show and demonstrate to the patient, tissue donor, or
research subject that he/she has not been coerced or deceived
(O'Neill 5). Thus, if this is the case, then it goes without saying
that a choice made by the patient should by borne of free choice
and free will. So, when asking for consent, medical
practitioners ought to do so in a manner that will offer patients
free will to make an informed choice. O’Neill argues that for
this to happen, consent ought to be viewed as a propositional
attitude, and it should neither be too vague as to fail legitimate
action, nor too detailed as to undermine the idea of informed
consent (5). Therefore, in order for informed consent to gain
legitimacy, free choice should be the guiding principle, as it
will demonstrate understanding and create trust in the medical
field.
Rebecca Skloot in The Immortal Life of Henrietta Lacks states
that Henrietta was often denied adequate information on her
ailment, treatment plan and use of harvested tissue. This was
not done illegally, based on the laws of the time when it was
ethical for doctors to carry out research and experiment on
subjects without them really knowing about it (100). However,
the manner in which it was done does not capture the spirit of
informed consent as it ought to be. This is because while
Henrietta was informed, the information offered was too vague;
for instance she was not informed that she would never have
children, and at the same time she was not asked for assent over
the use of her tissue. Thus, free choice was denied to Henrietta.
Informed consent at its most basic definition talks of “. . . a
person's expression of agreement with a proposed action”
(Singleton & Wadsworth 255). Therefore, it focuses on how a
person agrees or does not agree with an action, it does not give
an allowance of free choice on the part of the subject or patient.
Thus, the focus on informed consent is to simply adhere to

8. regulations governing medical research, without regards to
understanding on the part of the patient. In their research paper
Improving Participant Comprehension in the Informed Consent
Process Elizabeth Cohn and Elaine Larson point out that “. . .
despite increased regulatory scrutiny . . . increased attention by
institutional review boards to the consent process, no detectable
improvement in comprehension of informed consent is evident,
even in more recent studies” (279). Thus, informed consent
seems to be centered on the medical profession, and does not
focus on the patients, tissue donor or subjects, yet without input
from them, advances in medical science would stall. Cohn and
Larson thus state that”
A successful consent process must at a minimum include the use
of various communication modes—written, verbal, asking the
participant to repeat what he or she understands—and is likely
to require one-to-one interaction with someone knowledgeable
about the study, such as a consent educator (279).
Rebecca Skloot offers insights on what informed consent
entails, and when juxtaposed with informed consent, based on
free choice, it is clear that Henrietta Lacks was coerced, ergo
denied free choice and ‘informed consent’. So, in conclusion,
informed consent takes many forms, but the best form would be
one that embraces ‘free choice’ and does not guide, nor coerce
patients, research subjects or tissue donors towards consenting
for the sake of it, rather it should be consent borne of free will.
Works Cited
Cohn, Elizabeth, and Elaine Larson. "Improving Participant
Comprehension in the Informed
Consent Process." Journal of Nursing Scholarship 39.3 (2007):
273-280. 20 May 2013. Web.
O'Neill, Onora. "Some limits of Informed Consent." Journal of
Medical Ethics 29.1 (2003): 4-7.
20 May 2013. Web.
Singleton, Peter, and Michael Wadsworth. "Confidentiality and

9. Consent in Medical Research:
Consent for the Use of Personal Medical Data in
Research." BMJ: British Medical Journal 333.7561 (2006): 255.
20 May 2013. Web.
Skloot, Rebecca. The Immortal Life of Henrietta Lacks. New
York: Crown, 2010. Print.
Statements
Reasons
Step 1
Step 1
Step 2
Step 2
Step 3
Step 3
Step 4
Step 4
.
Step 5

10. Step 5
.
Step 6
Step 6
Step 7
Step 7
Step 8
Step 8
Step 9
Step 9
Step 10
Step 10
Note: The number of rows/steps provided in the proof table
above is arbitrary and not necessarily representative of the
number of statements needed to complete this proof logically.