The Potential Benefits of Informed Consent

Abstract

Our inquiry repeatedly tugs us back and forth. The law, rhetorically at least, advanced its doctrine of informed consent in terms of the fundamental principle of self-determination. Unfortunately, the law’s specific focus has come to be on torts and it thus provides little clear, specific guidance regarding how informed consent should actually pursue such self-determination. Concurrently, the law tends to induce behaviors in clinicians that are counter-productive. The new ethos of patient autonomy, for its part, enjoys broad societal consensus regarding many of its basic prescriptions. Further, like the law, the new ethos seems to presume that certain needs as well as patient abilities are usually present in the same form and degree. But such univocal presumptions regarding patient abilities and needs clearly run afoul of clinical experience and its supporting empirical literature. The icing on the cake is then supplied by reflecting on the diminishment of and barriers to autonomy that are ingredient in the clinical milieu, especially when we think of the “essay mode” of understanding, which is surely what we should hope for.