Unspoken Medical Ethics: The Hidden Side of Informed Consent; Griffin Trotter, PhD, MD

The doctrine of informed consent is the centerpiece of practical medical ethics, and many of the most pressing controversies in medical ethics pertain to situations where applications of this principle become tricky. For instance, informed consent procedures are disrupted when patients are too sick, too demented, too young, too intoxicated, or otherwise unable to give consent in the normal fashion — and each of these barriers to informed consent has elicited brisk medical ethics discussions. Behind informed consent is the principle of autonomy, namely the belief that patients ought to govern their own medical treatment. This lecture reviews informed consent, but then probes further by asking whether or to what extent genuine patient autonomy, and informed consent, are even possible in a medical system where treatment decisions are increasingly shaped by forces outside the patient-physician relationship.