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Informed Consent in Clinical Medicine^*

^* From the Division of Pulmonary and Critical Care Medicine, Department of Medicine, The Johns Hopkins Medical Institutions, Baltimore, MD.

Correspondence to: Peter B. Terry, MD, MA, FCCP, The Johns Hopkins Hospital, Blalock 910-Pulmonary/CCM, 600 North Wolfe St, Baltimore, MD 21287; e-mail: pterry{at}jhmi.edu

Abstract

Over the past third of a century, there has been a revolution in the way that health-care providers and patients make most medical decisions. Paternalism has slowly gone the way of the long-play record, and in its place has emerged a consent process in which the patient is a more fully informed and active participant. This process takes time however, and for the busy health-care provider there is often the temptation to hand the patient a consent form to sign. It is important to realize that signing a consent form does not constitute informed consent. True informed consent is a process, and, as such, it requires that the health-care provider enter into a discussion that ultimately leads to the patient understanding of their options, and the risks and benefits of the alternative courses of action. The purpose of this article was to describe, in some detail, the consent process in practical clinical terms, and to note when and how it should be obtained.

Key Words: decision making • ethics • informed consent

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