AUTONOMY VS.

PATERNALISM:
A Contest Between Virtues
INFORMED CONSENT
 Objectives:

• Define informed consent.

• Define and list the elements of informed consent.
• Differentiate between the professional community standard and
the reasonable patient standard, and explain how the latter
better serves the needs of the autonomous patient.
 Informed consent
• binds the physician to an adequate disclosure and explanation of the
treatment and the various options and consequences.

• occurs when communication between a patient and physician results

in the patient’s authorization or agreement to undergo a specific

medical intervention.
 Elements of Informed Consent:

A. Disclosure
B. Understanding
C. Voluntariness
D. Competence
E. Consent
 A. DISCLOSURE

The nature of the condition, the various options, potential risks, the
professional’s recommendation, and the nature of consent is an act
of authorization.
 B. UNDERSTANDING

The physician provide information at a level that a hypothetical

reasonable patient would understand.
 C. VOLUNTARINESS

No efforts toward coercion, manipulation, or constraint are

allowed. The patient must be in a position to practice self-
determination.
 D. COMPETENCE

Decisions usually take into account experience, maturity,

responsibility, and independence of judgment.
 E. CONSENT

An autonomous authorization of the medical intervention.

The concept of “consent”, according to Vaughn, involves some

assumptions to be validated. “Typically, an informed consent only exists

if, necessarily, the patient is competent to decide; if he/she is properly

provided with information; if he/she understands the information

provided; if he/she voluntarily decides on the treatment; and finally, if

he/she consents to be submitted to the procedure proposed.”

 Forms of Consent

A.Oral consent
B.Implied consent
C.Written consent
 A. ORAL CONSENT

• requires collaboration which is difficult to prove when there is

disagreement.
 B. IMPLIED CONSENT

• is often used in cases in which immediate action is required to

save a patient from death or permanent impairment of health.
 C. WRITTEN CONSENT

• provides legal, visible proof of the patient’s intentions in the

matter.
 STANDARDS OF DISCLOSURE

• It is informed consent that allows autonomous self-determination.

• To determine what standards should govern the level of disclosure.
• Two standards have been proposed: the professional community
standard and the reasonable patient standard.
 Professional Community Standard

• This reflects the professional point of view. In this view, the

health provider's responsibility is limited to the disclosures that a
health professional, practicing as a specialist in the field, would
make under the same or similar circumstances.   
 Reasonable Patient Standard

• This test reflects the patient's point of view. A patient-oriented

standard of disclosure means that the health provider is required
to disclose all facts, risks, and alternatives that a reasonable
person in the patient's situation would consider important, in
deciding to have, or not have, a recommended treatment.