Friday, September 17, 2021

Medical recommendations and informed consent

It is widely accepted that medical treatments require informed consent from the patient. This requires medical professionals to educate patients, to a reasonable degree, on the relevant scientific aspects of the treatment.

Interestingly, I have been told by a medical ethicist that it is not widely accepted that medical recommendations, whether from one’s individual physician or from a government body, are governed by similar informed consent standards. Thus, before giving you an injection, the physician is required to give you both the medical pros and cons of the injection, but if the physician recommends exercise to you, there is no such education requirement (e.g., the physician is not required to tell a clueless patient that exercise can result in joint pain).

This view seems wrong to me. The main reason for requiring informed consent is patient autonomy. But autonomy can be compromised just as much by recommendations omitting salient information as by actual treatment. Let’s say that Jeeves is annoyed by Wooster’s ugly mustache, and recommends to a Wooster the deliciousness of a particular brand of chocolate, having heard from the factory owner's valet that this brand has been contaminated with a chemical that makes one’s facial hair fall out. Jeeves has violated Wooster’s bodily autonomy through the recommendation almost as much as if Jeeves had shaved Wooster in the night.

1 comment:

William said...

Usually information given to enable informed consent is to enable the patient to make a decision based on knowledge about benefits and risks which they would not possess without being informed by the medical expert. The idea is to have the patient have a knowledge set sufficient to make a decision using facts that they would not otherwise know outside of specific medical education.

For this reason, risk information outside of specific medical facts might not be included as part of informed consent except as implied, since they might be known to the patient already. So, a fact that eating a lot of chocolate might cause weight gain would not be a special bit of information, but that a particular bit of chocolate would cause hair loss would be.

Whether a risk of exercise is a special one that should be included in medical informed consent depends on how commonplace such a bit of information is and whether it would be expected to be part of medical education and not a part of general knowledge.