Chapter 6: Rights, Truth and Consent
Section 3. Presentation of Issues: INFORMED CONSENT
If humans are autonomous moral agents who make decisions freely and are held morally responsible for the consequences of their actions then in order to make the decision the agent needs to have accurate information concerning the situation and not be under coercion of any form. Hence, there is a principle of Informed Consent in both moral theory and in the legal statutes.
Functions of the principle of Informed Consent:
A Health Care Provider must reveal to the recipient of care what is in that person's best interests to know. The recipient has a right to self decision and this shapes the Health Care Provider's duty to reveal the information. This might not be the customary practice for many HCP's. The HCP must provide all material risks. It is a material risk if a reasonable person in the recipient's condition would likely attach significance to the risk.
Terms as declared by Spotswood W. Robinson in Canterbury vs Spence allow for two (2) exceptions:
1. The recipient is unconscious and then there is no need for consent, particularly in an emergency situation
2. Disclosure is contra indicated from a medical point of view because the recipient would become so ill or emotionally distraught as to:
However, the HCP must respond to sound medical judgment. The privilege to withhold information is carefully circumscribed . The privilege is limited and does not permit paternalism.
So for informed consent a person must have the following:
Concerning competency there are important considerations and issues:
James Drane, Competency to Give an Informed Consent: A Model for Making Clinical Assessments, JAMA: Journal of the American Medical Association, August 17, 1984, Vol. 252, No. 7, pp. 925-927.
Freedman, Benjamin. A moral theory of informed consent. Hastings Center Report , August, 1975, pp.149-157.
Important questions concerning informed consent:
For answers READ: http://depts.washington.edu/bioethx/topics/consent.html
Informed Consent - History of Informed Consent
Informed Consent - The Need For Informed Consent
Informed Consent to Medical Treatment: Medical Malpractice
Clinical Trial - Informed Consent
Patient's Advocate Interviews Schizophrenic Patient http://www.youtube.com/user/overtree#p/u/6/KT1JAHPGZts
Kluge, Eike-Henner W. After "Eve": whither proxy ;decision-making? Canadian Journal Association Journal, (137), October 15,1987, p.715-720.
What of people who may not be able to choose?
Children and adults with deficiencies who:
Can such people be interfered with and decisions made for them in order to bring about what they would choose if they were fully rational and functional?
How do we decide what a rational person would or should do? This is a particularly difficult task when there are conflicting goods or alternatives.
Parents and Children
Parents are expected to make the decisions in the best interest of the children. Parents must not be: psychotic, incompetent, depressed or negligent. The State protects the interest of the children (citizens) from harm, even from parents. However , 44 states have made exceptions to the laws against child abuse and neglect in the case of those parents who act out of sincere religious beliefs.
Questions On Parental Consent:
History of the Massachusetts Religious Exemption Law
Cases of Childhood Deaths Due to Parental Religious Objections to Necessary Medical Care
Victims of Religion Based Medical Neglect
Listing of Religious Groups that Promote Faith Healing and Cases:
Pregnancy and Autonomy : Conflict of Rights? Woman vs fetus?
Can a pregnant woman be forced to stop doing something or forced to do something without her consent? Can the woman be coerced based upon concern for the welfare or the fetus or developing child within her? What are the possible relationships of the pregnant woman to the fetus?
There are those who maintain that actions have consequences and the pregnant woman accepts those consequences. The issue is just how far can a state go in prescribing the behavior of a pregnant woman? Should we establish a basic minimum or an obtainable ideal as the limit?
King, Patricia. (1986). Should mom be constrained in the best interests of the fetus? Nova Law Review, 13(2), pp. 343-348.
READ: South Carolina- Cornelia Whinter Case: http://www.aclu.org/news/w071596a.html
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© Copyright Philip A. Pecorino 2002. All Rights reserved.
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