Lead Query: Is Informed Consent Necessary for the Morality of Medicine and Healthcare?

Lead Query: Is informed consent necessary for the morality of medicine and healthcare?

My major claim is that Informed consent is a necessary, essential process in which communication between physician and patient is encouraged. It also helps to give confidence to the patient during the decision making process. Robert M. Arnold and Charles W Lidz assert in the opening statement of their Ð''yes' argument that: "Informed Consent in clinical care is an essential process that promotes good communication and patient autonomy despite the obstacles of implementation."[Arnold, Lidz, Pg 2]

I think that the informed consent is not only the piece of paper the patient is asked to sign, but a decision that should be weighted very carefully. It should only be given after very careful consideration and after there is an appreciation and understanding of the facts given. The patient should be made aware of not only the benefits, but also the demerits. In other words the patient should be made aware of the implications of their decisions, which would then be based on the intimate understanding of the facts.

It used to be that patients trusted their doctors completely and had absolute confidence in whatever decisions were made for them, but these days the doors of communication are now 2-way streets and the patient's right to autonomy is encouraged.

"The concept that medical decision making should rely exclusively on the physician's expertise has been replaced by a model in which healthcare professionals share information and discuss alternatives with patients who then make the ultimate decisions about treatment." [Arnold, Lidz, pg 4]

Onora O'Neill, in her "No" argument asserts that although the informed consent helps to educate the patient, it empowers the patient to a fault. "What we now see is a relationship between equals: the patient too is a professional, dressed in a suit and sitting like an equal at the desk; the patient has heard a full explanation and is being offered a consent form; he is deciding whether to give his fully informed consent" [O'Neill, pg 16]

She also argues that because of the informed consent, there is no longer a relationship between the physician and the patient. She asserts that the relationships have become an automated formality.

"However, at a time at which the real relations between doctors and patients are no longer personal relationships, nor even one-to-one relationships, but rather relationships between patients and complex organizations staffed by many professionals, the older personal, trust-based model or doctor Ð'-patient relationships seems increasingly obsoleteÐ'....The very requirement to record and file medical information, for example, while intended to control information and protect patients, can inhibit doctors; abilities to communicate freely."[O'Neill pg 18]

Onora O'Neill makes valid assertions, but I disagree with them. In her assertion about the educated patient who is also a professional and is well informed about the decision they are about to make, she claims that the information given levels the playing field for both patient and physician because they are both professionals. I disagree with that because unless the patient is a medically trained professional in the same field in which he seeks help, the doctor has more knowledge and more experience and thus has the upper hand and information which could be potentially