The value and practical limits of informed consent

doi:10.1017/CBO9780511545467.011

8 - The value and practical limits of informed consent

Published online by Cambridge University Press: 08 August 2009

Merle Spriggs

Edited by

Steve Clarke and

Justin Oakley

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Merle Spriggs: Affiliation:
Murdoch Childrens Research Institute, Parkville, Australia
Steve Clarke: Affiliation:
University of Oxford and Charles Sturt University, New South Wales
Justin Oakley: Affiliation:
Monash University, Victoria

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Summary

Introduction

Obtaining informed consent from patients and research subjects is often seen as an impossible goal. Practical difficulties abound in the disclosure of information, the processing of information and with patient understanding of information. Some people view these practical difficulties as limitations of informed consent. These difficulties and perceived limitations are some of the objections appealed to when it is suggested that patients offered surgery should have access to information about individual clinicians' performance (Clarke, this volume; Clarke and Oakley, 2004). In this chapter I outline the requirements for informed consent and comment on the moral authority of informed consent. I then outline recent influential criticisms of informed consent by Onora O'Neill and Carl Schneider and assess the main practical limitations these authors identify. Based on this assessment, I argue that the practical difficulties can be dealt with – they do not rule out the possibility of informed consent. Instead of practical difficulties, major impediments to achieving informed consent are the result of a failure to adequately value patient autonomy (the value underlying informed consent) and relying on an impoverished or underdeveloped view of autonomy. I argue that a proper understanding of informed consent and patient autonomy clarifies the ethical obligations of health care professionals. A proper understanding of informed consent and patient autonomy also shows us that there is an ethical obligation to provide information about individual clinicians' ability to perform an intervention. I conclude by considering the effect on the doctor–patient relationship of providing information about clinician performance.

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Type: Chapter
Information: Informed Consent and Clinician Accountability
The Ethics of Report Cards on Surgeon Performance
, pp. 134 - 146

DOI: https://doi.org/10.1017/CBO9780511545467.011 [Opens in a new window]

Publisher: Cambridge University Press

Print publication year: 2007

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