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Informed consent: moral necessity or illusion?
  1. L Doyal, professor of medical ethics
  1. St Bartholomew's and The Royal London School of Medicine and Dentistry, Queen Mary & Westfield College, University of London, London E1, UK
  1. Professor L Doyal l.doyal{at}


There is a professional and legal consensus about the clinical duty to obtain informed consent from patients before treating them. This duty is a reflection of wider cultural values about the moral importance of respect for individual autonomy. Recent research has raised practical problems about obtaining informed consent. Some patients have cognitive and emotional problems with understanding clinical information and do not apparently wish to participate in making decisions about their treatment. This paper argues that such research does not undermine their potential to provide informed consent. Rather, sufficient resources are required to create better communication skills among clinicians and more effective educational materials for patients. Finally, cognitive and emotional inequality among patients is maintained to be a reflection of wider social and economic inequalities. Researchers who take the right to informed consent seriously should also address these.

  • patient preference
  • risk
  • informed choice
  • decision making
  • patient-caregiver communication
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