The Myth of Informed Consent: In Daily Practice and in Clinical Trials
Silverman, William A.
Journal of Medical Ethics. 1989 Mar; 15(1): 6-11.
Until about thirty years ago, the extent of disclosure about and consent-seeking for medical interventions was influenced by a beneficence model of professional behaviour. Informed consent shifted attention to a duty to respect the autonomy of patients. The new requirement arrived on the American scene in two separate contexts: for daily practice in 1957, and for clinical study in 1966. A confusing double standard has been established. 'Daily consent' is reviewed, if at all, only in retrospect. Doctors are merely exhorted to obtain informed consent; they often minimise uncertainties about 'best' treatment and they feel duty-bound to provide patients with an unequivocal recommendation for action. 'Study consent' in a clinical trial is reviewed prospectively, and doctors are compelled by regulation to point out that there is insufficient evidence to make a rational choice between two compared treatments....
Alternatives; Autonomy; Beneficence; Clinical Trials; Consent; Decision Making; Disclosure; Drugs; Doctors; Government; Government Regulation; Human Experimentation; Informed Consent; Justice; Legal Aspects; Patient Care; Patients; Physicians; Random Selection; Regulation; Research; Research Subjects; Risks and Benefits; Standards; Surgery;
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