Informed Consent: A Study of Decisionmaking in Psychiatry

Hailed by its proponents as a doctrine that promises more equitable doctor-patient relationships, informed consent has also been decried as posing serious threats to the quality of care in this country. Ultimately, what is at stake in the controversy is nothing less than two equally entrenched but compelling strains in American legal and political history--the protection of individual autonomy versus societal regulation of individual freedom for the greater common good. In the case of psychiatric patients, the issue is further complicated because it is often precisely the patient's very capacity for autonomous action that is in question. Central to the ethical doctrine of informed consent is that patients not only be apprised of and give their written consent to a particular treatment--as required by law--but that they understand what the treatment entails and consent to it.