Patient Information and Consent: Self-Determination versus Paternalism

Abstract

One of the remarkable features of medical ethics in Imperial Germany was its ambiguous and sometimes openly controversial relationship with the law. An area where a conflict between doctors’ and lawyers’ differing conceptions of the therapeutic relationship was played out was the issue of patient consent to medical interventions, in particular to surgical operations. This chapter traces the debate on this issue from its beginnings in the early 1890s to the First World War. As I will show, the traditional paternalism of physicians and surgeons was challenged in court decisions, which forced them to adopt practices of consent-seeking and to consider the appropriate amount of patient information before treatment. However, in spite of those new requirements, doctors kept a paternalistic attitude.