Abstract
This paper is an empirical and normative study of several problems about informed consent in the law and in biomedical ethics. Its particular focus is on the adequacy of prevailing standards of informed consent in medicine and law. These standards generally govern adequate disclosure on the physician's part, to the relative neglect of the equally significant question, ‘What constitutes a valid consent on the patient's part?’ New empirical data regarding the actual decision-making behavior of patients is presented. It was gathered by studying patients considering whether to consent to the use of nonsurgical contraceptive techniques. Three hypotheses are examined regarding how disclosed information affects the decision-making process. Results indicate that disclosed information is not avowed as the prime determinant of the consent decision, that disclosed information does have some effect on the decision-making process, and that disclosed information does not impair or confuse the decision-making process. In conclusion, a number of implications for major areas of ethics and law are pointed out, with special emphasis on three areas of law: the materiality standard, causation, and the therapeutic privilege.
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Bibliography
AlfidiR. J.: 1971, ‘Informed consent: A study of patient reaction’, The Journal of the American Medical Association 216, pp. 1325–1329.
American Medical, Association, Judicial Council: 1968, ‘Ethical guidelines for organ transplantation’, The Journal of the American Medical Association 205, pp. 341–342.
Barnette v. Potenzo: 1974, 79 Misc. 2d 51, 359 N.Y.S. 2d 432 (Sup. Ct., Trial Term, Nassau Ct. 1974).
Canterbury v. Spence: 1972, 464 F.2d 772 (D.C.C.A. 1972).
CapronA. M.: 1974, ‘Informed consent in catastrophic disease research and treatment’, University of Pennsylvania Law Review 123, pp. 340–438.
Cobbs v. Grant: 1972, 8 Cal. 3d 229, 104 Cal./Rptr. 505, 502 P.2d 1 (1972).
EpsteinR. L. and D. J.Benson: 1973, ‘The patient's right to know’, Hospitals 15, pp. 47–52.
FadenR. R.: 1977, ‘Disclosure and informed consent: Does it matter how we tell it?’, Health Education Monographs 5, pp. 198–214.
FellnerH.: 1971, ‘Selection of living kidney donors and the problem of informed consent’, Seminars in Psychiatry 3, pp. 70–85.
FellnerC. H. and J. R.Marshall: 1970, ‘Kidney donors — the myth of informed consent’, The American Journal of Psychiatry 126, pp. 1245–1251.
Fogal v. Genesee Hospital: 1973, 41 App. Div. 2d 468, 344 N.Y.S.2d 552 (App. Div. 1973).
GlassE. S.: 1970, ‘Restructuring informed consent: Legal therapy for the doctor-patient relationship’, The Yale Law Journal 79, pp. 1533–1576.
GrayB. H.: 1975, Human Subjects in Medical Experimention: A Sociological Study of the Conduct and Regulation of Clinical Research (John Wiley & Sons, New York).
Hibbard, L.T.: 1974, ‘The issue of informed medical consent’, Los Angeles Times, December 22, 1974, Letter to the Editor.
Holt v. Nelson: 1974, 11 Wash. App. 230. 523 P.2d 211 (Ct. App. 1974).
LukerK.: 1975, Taking Chances: Abortion and the Decision Not to Contracept (University of California Press, Berkeley).
MarascuiloL. A. and M.McSweeney: 1977, Non-Parametric and Distribution-Free Methods for the Behavioral Sciences (Brooks/Cole Publishing Co., Monterey).
MarkhamB. B.: 1975, ‘The doctrine of informed consent — fact or fiction?’, The Forum (American Bar Association) 10, pp. 1073–1079.
McGuireW. J.: 1972, ‘Attitude change: The information-processing paradigm’, in Experimental Social Psychology, C. G.McClintock, ed. (Holt, Rinehart & Winston, New York), chap. 5, pp. 108–141.
MillJ. S.: 1859, On Liberty (John W. Parker & Son, London).
Miller v. Kennedy: 1974, 11 Wash. App. 272, 522 P.2d 852 (Ct. App. 1974).
New York University Law Review: 1973, ‘Informed consent — a proposed standard for medical disclosure’, New York University Law Review 48, pp. 548–563.
NisbettR. E. and T. D.Wilson: 1977, ‘Telling more than we can know: verbal reports on mental processess’, Psychological Review 84, pp. 231–259.
ProsserW. L.: 1971, Handbook of the Law of Torts, 4th ed. (West Publishing Co., St. Paul).
RosenbergS. H.: 1973, ‘Informed consent: A reappraisal of patients’ reactions, California Medicine: The Western Journal of Medicine 119, pp. 64–68.
RubsamenD. S.: 1974, A Medical-Legal Guide for the Health Sciences (University of California Press, Berkeley).
Rutgers-Camden Law Journal: 1975. ‘Medical treatment and human experimentation: Introducing illegality, fraud, duress, and incapacity to the doctrine of informed consent’, Rutgers-Camden Law Journal 6, pp. 538–565.
SlovicP., B.Fishhoff and S.Lichtenstein: 1977, ‘Behavioral decision theory’, Annual Review of Psychology 28, pp. 1–39.
WaltzJ. F. and T. W.Scheuneman: 1970, ‘Informed consent to therapy’, Northwestern University Law Review 64, pp. 628–650.
Wilkinson v. Vesey: 1972, 295 A.2d 676 (R.I. 1972).
Yale Law Journal, The: 1974, ‘Informed consent and the dying patient’, The Yale Law Journal 83, pp. 1632–1664.
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We are grateful to Eileen Stoner and Ronald Serlin for their assistance in collecting and analyzing the data reported in this article.
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Faden, R.R., Beauchamp, T.L. Decision-making and informed consent: A study of the impact of disclosed information. Soc Indic Res 7, 313–336 (1980). https://doi.org/10.1007/BF00305604
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DOI: https://doi.org/10.1007/BF00305604