Chapter 3.C.1 (2.B.1)  Goals, Aspirations, Policies

Notes: The Theory and Practice of Informed Consent

Note 2. Informed Consent in Practice.

A.D. Naik et al. note that the “clinical application of the concept of patient autonomy has centered on the ability to deliberate and make treatment decisions (decisional autonomy) to the virtual exclusion of the capacity to execute the treatment plan (executive autonomy).” A.D. Naik et al., Patient Autonomy for the Management of Chronic Conditions: A Two-Component Re-Conceptualization, 9:2 Am J Bioeth. 23-30 (2009). The authors suggest that a “two-component re-conceptualization of autonomy” should be applied to patients with chronic conditions: the “clinical assessment of capacity for patients with chronic conditions should be expanded to include both autonomous decision-making and autonomous execution of the agreed-upon treatment plan.”For responses, see P.S. Appelbaum, Decisional versus performative capacities: not exactly a new idea, 9:2 Am J Bioeth. 31-2 (2009); B. Russell, Patient autonomy writ large, 9:2 Am J Bioeth.32-4 (2009); J.P. DeMarco & D.O. Stewart, Expanding autonomy; contracting informed consent, 9:2 Am J Bioeth.35-6 (2009). For Naik and colleagues’ response to comments, see Naik et. al., Response to commentaries on “Patients autonomy for the management of chronic conditions: a two-component re-conceptualization,” 9:2 Am J Bioeth. W3-5 (2009).