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Dominic Wilkinson1,2,3,4,5, Neil Levy6,7

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Informed consent must consider how patients gain knowledge to make autonomous decisions. Reframing consent around

Keywords:
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Area of Science:

  • Bioethics
  • Medical Law
  • Philosophy of Medicine

Background:

  • Patient autonomy is a cornerstone of informed consent in medical practice.
  • Current informed consent models often overlook the epistemic dependencies inherent in exercising autonomy.
  • Understanding these dependencies is crucial for ethical medical decision-making.

Purpose of the Study:

  • To apply the philosophical concept of autonomy 'scaffolding' to informed consent in medicine.
  • To re-evaluate existing methods of decision support within the doctor-patient relationship.
  • To explore the implications for high-stakes medical decisions and the role of influence.

Main Methods:

  • Philosophical analysis of autonomy scaffolding.
  • Examination of existing models of the doctor-patient relationship.
  • Application of relational autonomy theories.

Main Results:

  • Scaffolding autonomy provides a new justification for current decision-support practices.
  • It suggests a need to revise consent procedures regarding timing, location, and method.
  • Technology may play a significant role in enhancing patient decision support.

Conclusions:

  • Informed consent should be understood as a process that scaffolds patient autonomy, acknowledging epistemic dependence.
  • High-stakes decisions require protection from undue influence, not complete absence of influence.
  • This framework offers a nuanced approach to ethical medical decision-making and consent processes.