The ethics of informed consent: an overview.

For the past twenty years patient consent to medical intervention has, increasingly, been required to be informed. For consent to be fully informed, the physician has to address five areas: 1) the nature; 2) purpose; 3) risks; 4) benefits of; and, 5) availability of alternatives to the proposed procedure. There are four exceptions to these requirements: 1) emergency; 2) waiver; 3) incompetence; and, 4) therapeutic privilege. There are ethical issues related to each of these nine dimensions of informed consent. Additionally, three issues pertinent to the discussion have been neglected in the literature: confidentiality, the cost of care and consent under duress. All these issues need to be considered in the context of the discrepency between the current theory and the current practice of informed consent.