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How changes in health care practices, systems, and research challenge the practice of informed consent
Jason H T Karlawish1, Ellen Fox, Robert Pearlman
1Department of Medicine, Division of Geriatric Medicine, University of Pennsylvania, Alzheimer's Disease Center, Philadelphia, Pennsylvania, USA. jasonkar@mail.med.upenn.edu
Abstract:
Informed consent has been the central model for ethical decision making in clinical care and research. The goal of informed consent is to protect the right of a competent person to make his or her own health care decisions based on personal values and goals. But changes in health care practices, systems, and research have challenged this well-established goal. This paper examines these changes to show that decisions about care and research directed to individual patients rely more and more upon a population perspective. As a result, efforts to promote patient choice should attend to the ethical decision-making processes of institutions that create and sustain this perspective.