Bioethical Principles Involved in the Informed Consent

Abstract

The socio-political transformations occurred during modern times generated a radical shift in self-perception of individuals. They no longer see themselves as subjects. Religious and political paternalism have become extinct, and now people demand to be recognized as autonomous individuals capable of deliberation. The term, citizen, becomes stronger and they themselves ask to be heard and respected as active participants in shaping social reality. The practice of medicine is not indifferent to these processes and the atavistic model (the genetic condition that is inherited from past generations) which applies to the paternalistic, clinical relationship, where the professional, due to their qualifications and based on welfare, decided what was best for the patient, started to crumble. Now, the patient requires an active recognition of their autonomy, which entails a new way of exercising the clinical setting through dialogue and deliberation. This new patient-citizen initiative, which is subject to rights and duties, requires self-judgment in various medical scenarios that determine one’s health. In this scenario, informed consent arises, and although autonomy is often stated to be the principle behind it, which states that decision- making related to health must respect the subjectivity of the patient, it needs, as an integral process of other principals, generators of early duties in the other protagonist of the clinical setting: the clinician. Non-maleficence and justice constitute the framework that determines the limitations of the range of decisions to make, between professional and patient.