Some limits of informed consent

Abstract

Many accounts of informed consent in medical ethics claim that it is valuable because it supports individual autonomy. Unfortunately there are many distinct conceptions of individual autonomy, and their ethical importance varies. A better reason for taking informed consent seriously is that it provides assurance that patients and others are neither deceived nor coerced. Present debates about the relative importance ofgenericandspecificconsent (particularly in the use of human tissues for research and in secondary studies) do not address this issue squarely. Consent is a propositional attitude, so intransitive: complete, wholly specific consent is an illusion. Since the point of consent procedures is to limit deception and coercion, they should be designed to give patients and others control over the amount of information they receive and opportunity to rescind consent already given.

Information and informed consent in a longitudinal screening involving children: a questionnaire survey

“…What constitutes relevant beliefs may vary with the situationundoubtedly, there is a difference between giving informed consent to a clinical standard intervention (for example a minor surgery) and consenting both for oneself and one's child to participate in a longitudinal preventive screening. 24,25 In general, understanding in order to make wellinformed decisions in order to, for example, participate in medical research seem to be problematic: international studies point to the need for a continuous discussion on how to best enable (potential) research subjects to make informed decisions. Lack of understanding among participants has been faced on several occasions: a number of empirical studies reveal difficulties regarding the comprehension of clinical trials, for example, therapeutic misunderstandings, inadequate information and unawareness of options and potential risks and benefits.…”

Should Non-Invasiveness Change Informed Consent Procedures for Prenatal Diagnosis?

“…[7] Second, a well-designed informed decision-making procedure can protect women from being deceived or coerced. [12] Third, such procedures exercise respect for autonomy and autonomy is intrinsically valuable. Finally, and more pragmatically, informed decisionmaking can also protect health professionals from complaints and litigation.…”

Relational conceptions of paternalism: a way to rebut nanny-state accusations and evaluate public health interventions

“…7,15 There are various ways of understanding consent, and the relation between consent and autonomy is complex. 16 We will assume that a non-consent condition is unnecessary given that an autonomy-undermining condition is central to the concept of paternalism. There are several reasons for this.…”

“…First, processes designed to attain consent are usually intended to ensure respect for autonomy, although their implications for autonomy in the more meaningful senses of that term are often very limited. 16,17 Respecting and/or promoting some of the conceptions of autonomy considered below is more demanding than simply attaining consent, but will also be likely to include something like working with rather than against or absent a person's will or consent, at least on things that matter to most citizens. Second, in a public health context, a requirement for active personal consent would essentially forbid most intervention, as it would be impractical to achieve this from individual citizens.…”