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. Author manuscript; available in PMC: 2022 Oct 28.
Published in final edited form as: Appl Ontol. 2022 May 4;17(2):321–336. doi: 10.3233/ao-210260

Table 1.

List of Permission-Sentences from Clinical Consent Forms which were included in this Evaluation. Note: By agreement with recruited facilities, we obscured facility names whose consent forms were not publicly available using “XXX”. For all facilities whose consent forms were publicly available, we did not remove identifiers.

Purposively Sampled Permission-Sentences
Reuse of Residual Clinical Biospecimens and/or Health Data
1. I hereby authorize XXX to retain, preserve and use for scientific or teaching purposes, or to dispose at its discretion or convenience, any specimen or tissues taken from my body during my visit.
2. I am a New York state resident and I give permission for GeneDx to retain any remaining sample longer than 60 days after completion of testing and use my de-identified data for scientific and medical research purposes.
3. I DONATE and authorize XXX to own, use, retain, preserve, manipulate, analyze, or dispose of any excess tissues, specimens, or parts of organs that are removed from my body during the procedures described above and are not necessary for my diagnosis or treatment.
4. I agree that any excess tissue, fluids or specimens removed from my body during my outpatient visit or hospital stay ( my specimens ) that would otherwise be disposed of by the Hospital may be used for such educational purposes and research, including research on the genetic materials (DNA).
5. I authorize the pathologist, at his or her discretion, to retain, preserve, use, or dispose of any tissues, organs, bones, bodily fluid or medical devices that may be removed during the operation(s) or procedure(s).
6. I hereby consent to the use and disclosure of my protected health information as described in the Notice of Privacy Practices.
Other Clinical Procedures and Activities
7. By signing this form, I am requesting and giving my consent for MHSM and the doctors and/or nurses to give me blood and/o [sic] blood products during this admission or series of treatments.
8. Your signature below indicates that you understand to your satisfaction the information about the genetic testing ordered by your health care provider and that you consent to having this testing performed.
9. I consent to the Facility videotaping, photographing, video monitoring, or taking other recordings of me or parts of my body for diagnosis, treatment, research, or patient safety purposes.
10. I also consent to diagnostic studies, tests, anesthesia, x-ray examinations and any other treatment or courses of treatment relating to the diagnosis or procedure described herein.
Randomly Sampled Permission-Sentences
11. I, , request and consent to the start or induction of my labor by my provider: and other assistants as may be selected by him/her.
12. I voluntarily consent to receive medical and health care services that may include diagnostic procedures, examination, and treatment.
13. I consent to the use of closed-circuit television, taking of photographs (including videos), and the preparation of drawings and similar illustrative graphic material for scientific purposes providing my identity is not revealed.
14. I hereby consent to engaging in virtual health/telemedicine services, where available, as part of my treatment.
15. In the event a healthcare worker is exposed to my blood or body fluids in connection with my procedure, or during my hospital stay, I agree to the collection and testing of my blood for HIV.