The conclusions of a ‘citizens’ jury’, reported recently in the British Medical Journal  shed light on some important weaknesses in the doctrine of ‘informed consent’. The doctrine is commonly thought of as canonical. Be careful about questioning its exalted status: you’ll be branded paternalistic at best, and the indictment may well involve unflattering comparisons with Dr. Mengele.
The ‘jury’, composed of 25 women, commented on how a leaflet on breast cancer screening should be re-drafted. The jury preferred:
– the term ‘overtreatment’ to ‘over-diagnosis’
-to express benefits in the language of lives saved rather than deaths avoided
– to talk about ‘benefits’ and ‘risks’ rather than ‘pros’ and ‘cons’
– to begin the leaflet by an up-beat reference to the numbers of lives saved by screening, followed by the caveat that a small number of women would be over-treated.
What was the priority: reassurance or accuracy? The majority (15), wanted both; 3 thought that reassurance was most important; 7 thought that accuracy was the priority.
How should one list the benefits and harms? Four thought they should be listed together in the same sentence, 8 that they should be listed separately, and 12 for mentioning them first separately and then together.
The point of all this is that there are innumerable different ways, all of which would be smiled on by Bolam , in which entirely accurate information can be conveyed. And yet tiny nuances are seen by the receivers of the information as significant. Continue reading →
- Podcast: Justifications for Non-Consensual Medical Intervention: From Infectious Disease Control to Criminal Rehabilitation
- How much would you pay to live an extra year?
- Loebel Lecture 3 of 3: What is the upshot?
- Lecture 2 of 3: Science is quietly, inexorably eroding many core assumptions underlying psychiatry
- Loebel Lectures and Workshop, Michaelmas Term 2015, Lecture 1 of 3: Neurobiological materialism collides with the experience of being human
- Loebel Lectures and Workshop, Michaelmas Term 2015, Lecture 1 of 3: Neurobiological materialism collides with the experience of being human on
- In defence of drinking alone on
- Why It’s OK to Block Ads on
- Podcast: Justifications for Non-Consensual Medical Intervention: From Infectious Disease Control to Criminal Rehabilitation on
- Guest Post: KILLER ROBOTS AND THE ETHICS OF WAR IN THE 21th CENTURY on