How changes in health care practices, systems, and research challenge the practice of informed consent.
Informed consent has been the central model for ethical decision making in clinical care and research. The goal of informed consent is to protect the right of a competent person to make his or her own health care decisions based on personal values and goals. But changes in health care practices, systems, and research have challenged this well-established goal. This paper examines these changes to show that decisions about care and research directed to individual patients rely more and more upon a population perspective. As a result, efforts to promote patient choice should attend to the ethical decision-making processes of institutions that create and sustain this perspective.
Karlawish
Jason H T
JH
Department of Medicine, Division of Geriatric Medicine, University of Pennsylvania, Alzheimer's Disease Center, Philadelphia, Pennsylvania, USA. jasonkar@mail.med.upenn.edu
Fox
Ellen
E
Pearlman
Robert
R
D003657:Decision Making; D003695:Delivery of Health Care / Q000592:standards*; D004992:Ethics, Medical; D019317:Evidence-Based Medicine; D005610:Freedom; D006805:Human Experimentation; D006801:Humans; D007258:Informed Consent; D008329:Managed Care Programs / Q000592:standards; D009936:Organizational Innovation; D010344:Patient Advocacy; D012106:Research / Q000592:standards*; D014481:United States