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Recent insights into decision-making and their implications for informed consent.
Irene M L Vos1, Maartje H N Schermer1, Ineke L L E Bolt1
1Department of Medical Ethics and Philosophy of Medicine, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands.
Journal of Medical Ethics
|July 23, 2018
Summary
Behavioral science reveals that human decision-making is often irrational, challenging the traditional doctrine of informed consent in medicine. Patient decision aids (PDAs) may help, but require improvements to truly support autonomous choices.
Area of Science:
- Behavioral Science
- Medical Ethics
- Decision-Making Theory
Background:
- Traditional informed consent doctrine assumes rational decision-making.
- Behavioral science research indicates human choices are often non-rational.
- This creates a tension with ethical and legal requirements in medical practice.
Purpose of the Study:
- To discuss the implications of decision-making research for informed consent.
- To explore responsible solutions for the identified tension.
- To propose improvements for patient decision aids (PDAs) to support autonomy.
Main Methods:
- Literature review of behavioral science research on decision-making.
- Analysis of the informed consent doctrine in light of empirical findings.
- Conceptual analysis of autonomy to inform PDA development.
Main Results:
- Significant tension exists between non-rational choice behavior and traditional informed consent theory.
- Current patient decision aids (PDAs) require enhancements to effectively promote autonomous decision-making.
- A specific conception of autonomy is needed to guide PDA improvements.
Conclusions:
- Informed consent requires re-evaluation due to non-rational decision-making.
- Patient decision aids are promising but need refinement.
- Improvements should focus on enhancing true patient autonomy in medical choices.
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