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[Informed consent in clinical practice: persistent doubts].

Miguel Kottow1

  • 1Facultad de Ciencias de la Salud, Universidad Central de Chile, Santiago, Chile, Miguel.kottow@ucentral.cl.

Revista Medica De Chile
|April 11, 2017
PubMed
Summary
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Informed consent procedures often become administrative, failing to provide true patient autonomy. The article proposes shifting focus from unlimited autonomy to strengthening trustworthiness in the patient-physician relationship for better medical care.

Area of Science:

  • Bioethics
  • Medical Ethics
  • Patient Autonomy

Background:

  • Informed consent emerged to counter 19th-century medical paternalism, empowering patients in decision-making.
  • Despite bioethics' efforts, informed consent has evolved into an impersonal, administrative process.
  • The inherent uncertainties in medicine limit the feasibility of complete information disclosure.

Purpose of the Study:

  • To critically evaluate the effectiveness of informed consent in achieving genuine patient autonomy.
  • To explore the tension between the pursuit of patient autonomy and the establishment of trust in clinical practice.
  • To propose a revised ethical framework prioritizing trustworthiness in the patient-physician relationship.

Main Methods:

  • Conceptual analysis of bioethical principles and their application to informed consent.

Related Experiment Videos

  • Review of the evolution of informed consent in medical practice.
  • Ethical argumentation regarding the balance between autonomy and trust.

    • Main Results:

    • Excessive information disclosure can lead to patient indecision and reliance on medical advice.
    • The fiduciary nature of the patient-physician relationship is undermined by an overemphasis on autonomy.
    • Patients often prioritize feeling protected and cared for over absolute autonomous decision-making.

    Conclusions:

    • Bioethics should temper its insistence on unlimited patient autonomy.
    • Strengthening the trust bond is paramount for effective clinical encounters.
    • Informed consent should be reconceptualized to foster trustworthiness in medicine.