Informed consent

Summary

Introduction

“Respect for persons requires that … to the degree that they are capable, [they] be given the opportunity to choose what shall or shall not happen to them. This opportunity is provided when adequate standards for informed consent are satisfied.”

(Belmont Report, 1979)

The doctrine of informed consent is the cornerstone of contemporary ethical practice in clinical medicine and psychology, and in research involving human subjects or human tissue. For the last quarter of a century, the principal framework for understanding informed consent in ethics and at law has been its role in promoting personal autonomy. The central ethical idea is that self-determination – here with regard to medical care/participation in research – is desirable in and of itself; it is through consent or refusal that we make our lives consistent with our values. Valid informed consent is the practical means by which the fundamental moral value of autonomy, in the sense of self-determination, is realized in healthcare decision-making.

Additionally, the practice of informed consent is thought to facilitate other factors integral to healthcare relationships. In both clinical and research encounters, patients and subjects are vulnerable parties in virtue of their lack of knowledge and in many cases, their ill health. Information and shared decision-making are thought to be potentially empowering. First, the information deficit is repaired. Secondly, since patients personally bear the burden of healthcare decisions, assisting them to make the best possible choices for themselves also realizes the professional goals of healthcare providers.