Neves, M.P. Med Health Care Philos (2004) 7: 93. doi:10.1023/B:MHEP.0000021678.07382.74
The theme of “consent” is, without question, associated with the origins of bioethics and is one of its most significant paradigms that has remained controversial to the present, as is confirmed by the proposal for its debate during the last World Congress of Bioethics. Seen broadly as a compulsory minimum procedure in the field of biomedical ethics, even today it keeps open the issues that it has raised from the start: whether it is really necessary and whether it can be proven to be effective. My goal will be to attempt to determine the most genuine and relevant meaning of “consent,” going back from its present dominant normative meaning and, from there, identifying or simply sketching other possible forms of its expression in the world we live in, so as to justify its pertinence and validity. This objective will involve three stages: (1) “‘Consent’ as a privileged paradigm of bioethics (the ethical-juridical sense),” (2) “The symbolic value of ‘consent’ (the social-cultural sense),” and (3) “‘Consent’ as promotion of the human (the humanistic-personal sense)”.It is concluded that the common notion of normative “consent” is not the only one, nor does it hold universal validity; that, from a historical-cultural perspective, new expressions of “consent” appear, adapted to different social contexts and to possibly be implemented in developing countries; and, finally, that “consent” is strictly indispensable in situations of extreme dependence, in its symbolic relational character, in as much as it promotes ethical relationships among strangers and ensures that they remain so.
bioethicsconsentethical-juridicalpersonsocial-cultural and humanistic-personal perspectivesethical relations