[The informed consent].

Abstract

To what extent can or should a patient influence medical decisions? For a valid decision to be made, it is usually considered essential that the patient be autonomous and competent. If a person is not incapacitated for autonomous action, he can accept or reject a medical intervention on the basis of the information available to him. This raises the question of what the patient is to be told. The answer rests on which value is considered fundamental in medical practice: the patient's well-being or respect for his status as a person. This controversy arises in both the strictly therapeutic and the research contexts. In both cases, information must be explicit and clear. Many printed forms are hard to understand; the patient's signature merely precludes the possibility of legal problems. Depending on the kind of disease and treatment, the patient's consent may at times be almost tacit while at other times it should be based on complete information, especially if his decision seems irrational or contrary to the physician's judgment. In clinical trials, information and consent problems usually relate to the possibility that information given the participant will invalidate the findings. Nevertheless, the patient's rights and well-being should always be considered more important than the research.