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First Published Online October 10, 2008
The Oncologist, Vol. 13, No. 10, 1109-1113, October 2008; doi:10.1634/theoncologist.2008-0101
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Medical Ethics

Informed Consent Revisited: A Doctrine in the Service of Cancer Care

Madeleine Schachtera, Joseph J. Finsa,b

aDivision of Medical Ethics, Weill Medical College of Cornell University, New York, New York, USA; bThe Rockefeller University, New York, New York, USA

Correspondence: Joseph J. Fins, M.D., F.A.C.P., Division of Medical Ethics, New York Presbyterian-Weill Cornell Medical Center, 435 East 70 Street, Suite 4-J, New York, New York 10021 USA. Telephone: 212-746-4246; Fax: 212-746-8738; e-mail: jjfins{at}med.cornell.edu

Received April 18, 2008; accepted for publication September 3, 2008; first published online in THE ONCOLOGIST Express on October 10, 2008.

Disclosure: The content of this article has been reviewed by independent peer reviewers to ensure that it is balanced, objective, and free from commercial bias. No financial relationships relevant to the content of this article have been disclosed by the authors, planners, independent peer reviewers, or staff managers.

Informed consent traditionally has been viewed as a safeguard for the protection of patients' decisional autonomy. While informed consent is a critical means for the protection of the patient's dominion over the integrity of his body, exclusive consideration of the doctrine as a safeguard for patients eclipses the doctrine's significant benefits for the therapeutic endeavor. Undertaking a thorough informed consent process helps the physician avoid the unilateral burdens of paternalism; furthers compliance with the doctor's legal obligations, ethical duties, and clinical responsibilities; and, as importantly, enhances the collaborative treatment enterprise.

When informed consent is viewed narrowly and solely as a protective device for patients' rights, the physician may be less likely to engage the patient in ongoing discussions. Important opportunities may be missed to elicit additional clinical information, assess psychosocial concerns, and reiterate the commitment to collaboration and patient autonomy.






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