Quiz Eleven Flashcards
informed consent
the action of an autonomous informed person agreeing to submit to medical treatment or experimentation
an ethical ideal in which MDs are obligated to tell pts about possible medical interventions and to respect their choices regarding them
rejects strong paternalism
promotes pt welfare
justification of informed consent
autonomy and beneficence
Schloendorff v. Society of New York Hospital
“every human being of adult years and sound mind has a right to determine what shall be done with his own body” but there was no suggestion that consent had to be informed
Salgo v. Leland Stanford Junior University Board of Trustees
informed consent created, “a MD violates his duty to his pt and subjects himself to liability if he withholds any facts which are necessary to form a basis of an intelligent consent by the pt to the proposed treatment”
Canterbury v. Spence
“the scope of the MD’s communication to the pt the must be measured by the pt need, and that need is the information material to the decision”
informed consent exists when-
the pt is competent
she gets an adequate disclosure of information
she decides voluntarily
she consents to the treatment
disclosure consists of-
the nature of the procedure
the risks
alternatives
expected beneifts
therapeutic privilage
the withholding of relevant information from a pt when the MD believes disclosure would likely do harm
utilitarianism on informed consent
wants to judge actions involving informed consent by the overall good they would produce. for the act-U this standard must be applied to each individual case and though freq used it is not a moral requirement, for rule -U the best overall consequences would be achieved if the MDs always used informed consent
Kantian ethics on informed consent
people are autonomous an must be respected, must voluntarily consent, therapeutic privilege is never permissible, waiver is allowed because it permits the choice of not choosing,
Rawls’ contract theory on informed consent
supports freedom and informed consent
Faden and Beauchamp
informed consent is a pts autonomous action that authorizes a course of action. the other common meaning of the term is defined legally or institutionally and does not refer to autonomous authorization
sense1- informed consent is analyzable as a particular kind of action by individual pts and subjects- autonomous authorization
must have- substantial understanding, be in substantial absence of control by others, intentionally, authorize a professional to do the intervention
if you don’t do the last one you have made an- informed refusal
sense2- informed consent is analyzable in terms of the web of cultural and policy rules and requirements of consent that collectively form the social practice of informed consent i institutional contexts where groups of pts and subjects must be treated in accordance with rules, policies, and standard practices- informed consent is not always autonomous nor always in any meaningful respect authorizations
effective consent is a policy oriented sense whose conditions are not derivable solely from analyses of autonomy and authorization or even from broad notions of respect for autonomy. informed consent does not refer to autonomous authorization but to a legally or institutionally effective authorization from a pt or subject.
Katz
genuine pt self-determination is still not the norm. the goal of joint decision making between pts and MDs is still unfulfilled. MDs must respect pt autonomy.
early 50’s, Talcott Parsons- laymen cant understand MDs, pts are anxious and incompetent because of their sickness affecting their processes, MDs commitment to altruism is good enough to prevent abuse of their power
rejecting informed consent is negligence
