The evolution of informed consent

Informed consent and the changes in what is expected over the 21st century provide an instructive case study of the mutual influence on one another of medical law and medical ethics. Over the years we have moved from a doctor-centred standard to a patient-centred standard and from a one-size-fits-all patient-centred standard to a more individual requirement that engages with the needs of a particular patient It is unreasonable to expect those changes to be reflected in anything less than an extended conversation in which the health care professional gives out some version of what a reasonable patient would expect to hear from an informed health care professional and then responds to the patient's questions as informatively and helpfully as he or she can. It is therefore convenient to refer to spontaneous and responsive disclosure as a very concrete implementation of the health care professional-patient partnership that is contemporary health care and at the heart of health care ethics.     

Adolescents' capacities to provide voluntary informed consent

Minors' capacities to provide a valid informed consent for the treatment of medical and psychological disorders are contingent in part on the determination of whether they can make voluntary treatment decisions. The gravity of a medical dilemma and the nature of parental influence are two factors hypothesized to effect and perhaps compromise the voluntariness of treatment decisions made by adolescents. In the present study 40 14- and 15-year-old subjects were asked to note their conviction for treatment decisions they had made in response to hypothetical medical dilemmas in which parental influence varied. It was found that adolescents making treatment decisions are generally deferent to parental influence, although they are more likely to resist parental influence when the consequences of the decision have serious implications for the hypothetical adolescent's health.This investigation was supported in part by a grant from the American Psychology-Law Society/ Division 41 of the American Psychological Association, whose assistance is gratefully acknowledged. Gratitude is also extended to the Albemarle County School District, the Blue Ridge School. and St. Anne's-Belfield for their kind cooperation. The authors wish to thank William Gardner, Jeanne Smith, and Edith Lawrence for their work on behalf of this project. Special recognition is due to Lois A. Weithorn for her guidance and support of this research endeavor.     

Medical: informed consent--designate health care professionals to obtain informed consent. Final rule

This document amends U.S. Department of Veterans Affairs (VA) medical regulations on informed consent. The final rule authorizes VA to designate additional categories of health care professionals to obtain the informed consent of patients or their surrogates for clinical treatment and procedures and to sign the consent form.     

The future of informed consent in British common law

Within the common law world, the use of the term informed consent implies the American doctrine. Informed consent as a doctrine is not part of the law in the United Kingdom. However, it is possible to predict a way forward in disclosure cases yet to be heard in the courts of the United Kingdom. These predictions are based on current developments in the common law in the United Kingdom as well as those in Canada and Australia, on the European Convention on Human Rights and Biomedicine and on trends within the medical profession itself in the light of the Bolam test.