RESUMO
The author in this article reviews recent changes in the conceptualization of informed consent in medical encounters to help provide a better understanding of the concept itself and of some difficulties that exist in philosophical justifications for the requirement of informed consent.
Assuntos
Consentimento Livre e Esclarecido , Humanos , Educação de Pacientes como Assunto , Relações Médico-PacienteRESUMO
This article describes three kinds of information constraints in medical encounters that have not been discussed at length in the medical ethics literature: constraints from the concept of a disease, from the diffusion of medical innovation, and from withholding information. It describes how these limit the reliance rational people can justifiably put in their doctors, and even the reliance doctors can have on their own advice. It notes the implications of these constraints for the value of informed consent, identifies several procedural steps that could increase the value of the latter and improve diffusion of innovation, and argues that recognition of these constraints should lead us to devise protections which intrude on but can improve these encounters.
KIE: The author contends that the informed consent of patients and research subjects to medical procedures is hampered by three types of information constraints that are independent of undue pressure or of the patients' or physicians' personal shortcomings. First, well-qualified doctors may disagree about the nature, treatment, and cure of particular diseases, especially when they are trained in different medical specialities. Secondly, successful new treatments may not be available to those who need them because of delay in the diffusion of medical innovations. Finally, doctors as well as patients may be misinformed or deceived by others as to the safety and efficacy of particular therapies. Ways of ameliorating these information constraints are suggested, and it is concluded that they warrant some degree of regulation over the practice of medicine, to protect physicians and patients alike.
