The impossibility of informed consent?

Abstract

The problematic nature of informed consent to medical treatment and research, and its relation to autonomy, trust and clinical practice, has been addressed on many occasions and from a variety of ethical perspectives in the pages of the Journal of Medical Ethics. This paper gives an account of how discussion of these issues has developed and changed, by describing a number of significant contributions to these debates which provide examples of 'doing good medical ethics' over the 40 years of the Journal's publication.

Defending the four principles approach as a good basis for good medical practice and therefore for good medical ethics

“…Several contributors echo widespread claims that respect for autonomy is given too much weight either at the expense of beneficence, for example Kong,7 Boyd,16 Hurwitz17 and Callahan,12 or at the expense of justice, for example Dawson,8 Cookson,9 Prah Ruger10 and Callahan,12 or at the expense of non-maleficence, for example Savulescu 18. These concerns point to the general problem of how to deal with conflict between these principles.…”

The New Trends in Medicine and Trust

“…The key principal of informed consent is the respect of patient's autonomy and his right to participate in treatment decision. This new code of medical practice is recognized and protected by law [2].…”

Reconsidering counselling and consent

“…Many aspects of informed consent remain contested philosophically and practically, with some even referring to the impossibility thereof . The process is influenced by confounding variables such as the particular decision, disease environment, culture and language.…”