Evolution of consent in clinical practice

In clinical care, disclosure of risk developed from the obligation on doctors to obtain their patients' consent before intervening medically. In absence of emergency, doctors who acted without their patients' consent were initially accused of battery or intentional harm and later of negligence. Gradually the notion of consent evolved into informed consent, with the emphasis being on information about risks.

US Supreme Court

Credit:KENNETH LAMBERT/AP

The professional standard of consent to treatment has been espoused as a judicial concept since a British case in 1767.1 In that case the physician initially set the patient's femoral fracture in accordance with practice at the time but at a follow up visit rebroke the healing fracture and placed the rebroken bone in a mechanical device with teeth. Physicians called into court to testify reported that physicians usually secured their patients' consent before embarking on a medical intervention, but there was little said in the judge's written opinion about what should be said to patients before an experimental intervention, as opposed to a clinical intervention. The judge concluded that …