Informed Consent

A brief review of the evolution of informed consent law will provide an understanding of the current status of the physician’s duties with respect to disclosure. The writings of Hippocrates, one of the earliest to discuss professional conduct, include phrases such as “concealing most things from the patient” and “revealing nothing of the patient’s future or present condition.” In that authoritarian age patients were expected to be obeisant, and the purpose of physician–patient communication was solely to persuade the patient to accept therapy. de Mondeville, a medieval physician, believed hope to be of sufficient therapeutic benefit to justify avoiding the truth. He advised, “Promise a cure to the patient but tell parents or friends of any danger.” In the nineteenth century, Benjamin Rush wrote, “Educate the patient about his condition.” His purpose for patient education was to motivate compliance with the advice of the physician. Although Rush thus proposed an informed patient decision, he was not an advocate of consent.