The Limits of Informed Consent for an Overwhelmed Patient: Clinicians' Role in Protecting Patients and Preventing Overwhelm

In this paper, we examine the limits of informed consent with particular focus on ways in which various factors can overwhelm decision-making capacity. We introduce overwhelm as a phenomenon commonly experienced by patients in clinical settings and distinguish between emotional overwhelm and informa...

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Bibliographic Details
Published in:AMA journal of ethics 2016-09, Vol.18 (9), p.869-886
Main Authors: Bester, Johan, Cole, Cristie M, Kodish, Eric
Format: Article
Language:English
Subjects:
Beneficence
Comprehension
Decision Making
Emotions
Ethics, Medical
Genetic Testing
Health Knowledge, Attitudes, Practice
Health Literacy
Humans
Informed Consent - ethics
Informed Consent - psychology
Paternalism
Patient Participation - psychology
Patients - psychology
Physician's Role
Physician-Patient Relations - ethics
Stress, Psychological
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Summary:In this paper, we examine the limits of informed consent with particular focus on ways in which various factors can overwhelm decision-making capacity. We introduce overwhelm as a phenomenon commonly experienced by patients in clinical settings and distinguish between emotional overwhelm and informational overload. We argue that in these situations, a clinician's primary duty is prevention of harm and suggest ways in which clinicians can discharge this obligation. To illustrate our argument, we consider the clinical application of genetic sequencing testing, which involves scientific and technical information that can compromise the understanding and decisional capacity of most patients. Finally, we consider and rebut objections that this could lead to paternalism.
ISSN:2376-6980
2376-6980
DOI:10.1001/journalofethics.2016.18.9.peer2-1609