How Changes in Health Care Practices, Systems, and Research Challenge the Practice of Informed Consent : Medical Care

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How Changes in Health Care Practices, Systems, and Research Challenge the Practice of Informed Consent

Karlawish, Jason H. T. MD*; Fox, Ellen MD†‡; Pearlman, Robert MD, MPH†§

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Abstract

Informed consent has been the central model for ethical decision making in clinical care and research. The goal of informed consent is to protect the right of a competent person to make his or her own health care decisions based on personal values and goals. But changes in health care practices, systems, and research have challenged this well-established goal. This paper examines these changes to show that decisions about care and research directed to individual patients rely more and more upon a population perspective. As a result, efforts to promote patient choice should attend to the ethical decision-making processes of institutions that create and sustain this perspective.

© 2002 Lippincott Williams & Wilkins, Inc.

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