"What are my options?": Physicians as ontological decision architects in surgical informed consent.

Publisher: Wiley-Blackwell Country of Publication: England NLM ID: 8704792 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1467-8519 (Electronic) Linking ISSN: 02699702 NLM ISO Abbreviation: Bioethics Subsets: MEDLINE

Publication: Oxford : Wiley-Blackwell
Original Publication: Oxford ; New York : Basil Blackwell, c1987-

Personal Autonomy* ; Physicians*; Humans ; Informed Consent ; Paternalism ; Physician-Patient Relations ; Decision Making

The aim of a theoretically ideal process of informed consent is to promote the autonomy of the patient and to limit unethical physician paternalism. However, in practice, the nature of the medical profession requires physicians to act as ontological decision architects-based on the medical knowledge that they acquire through their experience and training, physicians ontologically determine a subset of viable courses of action for their patient. What is observed is not an unethical physician limitation or biasing of the patient towards certain treatment options that violates patient autonomy or consciously undermines informed consent, but rather a more foundational paternalism that is necessarily inherent to the physician-patient relationship. In this article we argue for a recognition of this underlying physician paternalism and posit that this necessary paternalism is not a foil to patient autonomy, but rather a foundational aspect of the duties of the medical professional within the physician-patient relationship.
(© 2022 John Wiley & Sons Ltd.)

Keywords: decision architecture; informed consent; medical ethics; paternalism; patient relationship; physician; surgery

Date Created: 20220801 Date Completed: 20221021 Latest Revision: 20221214

20231215

10.1111/bioe.13076

35912521