[Patient autonomy and informed consent in clinical practice].
BACKGROUND
Patient autonomy and informed consent is increasingly emphasized in clinical practice, professional ethics and health care legislation.


METHODS
Literature on patient autonomy and informed consent was assembled, analyzed, and common norms compared with Norwegian legal regulations.


RESULTS
The procedure of obtaining informed consent may increase patient participation and prevent unwanted treatment and care. Such a practice is in line with the principle of patient autonomy. An act is normally considered autonomous when the following three criteria are fulfilled: Sufficient understanding, competence to consent and that the consent is given voluntarily. In clinical practice it is sometimes impossible to meet all these criteria. Furthermore, it is often demanding to tailor the information and the decision-making process to the individual patient's background and preferences. When the patient lacks competence to consent, the Norwegian health care legislation assigns an especially large responsibility to the health care personnel. Recently, health care personnel's authority to use force in such situations have been expanded.


CONCLUSIONS
The increased emphasis on patient autonomy and informed consent places high demands on health care personnel's moral considerations, ability to communicate, and understanding of roles and responsibilities. Assessment of competence to consent will probably become an important challenge to Norwegian health care personnel in the near future.
Pedersen
Reidar
R
Seksjon for medisinsk etikk, Universitetet i Oslo, Postboks 1130 Blindern, 0318 Oslo. reidar.pedersen@medisin.uio.no
Hofmann
Bjørn
B
Mangset
Margrete
M
D016223:Advance Directives / Q000941:ethics / Q000331:legislation & jurisprudence; D003142:Communication; D003657:Decision Making; D006801:Humans; D007258:Informed Consent / Q000941:ethics / Q000331:legislation & jurisprudence; D016743:Mental Competency / Q000331:legislation & jurisprudence; D009664:Norway; D010353:Patient Education as Topic / Q000941:ethics / Q000331:legislation & jurisprudence; D010358:Patient Participation / Q000331:legislation & jurisprudence; D026684:Personal Autonomy; D010817:Physician-Patient Relations / Q000941:ethics; D012307:Risk Factors