Free Choice and Patient Best Interests
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In medical practice, the doctrine of informed consent is generally understood to have priority over the medical practitioner’s duty of care to her patient. A common consequentialist argument for the prioritisation of informed consent above the duty of care involves the claim that respect for a patient’s free choice is the best way of protecting that patient’s best interests; since the patient has a special expertise over her values and preferences regarding non-medical goods she is ideally placed to make a decision that will protect her interests. In this paper I argue against two consequentialist justifications for a blanket prioritisation of informed consent over the duty of care by considering cases in which patients have imperfect access to their overall best interests. Furthermore, I argue that there are cases where the mere presentation of choice under the doctrine of informed consent is detrimental to patient best interests. I end the paper by considering more nuanced approaches to resolving the conflict between informed consent and the duty of care and consider the option of permitting patients to waive informed consent.
KeywordsBest interests Duty of care Free choice Informed consent Patient harm
I would like to thank the anonymous reviewers and a number of friends and colleagues for their comments on earlier drafts. In particular, Philip Goff, Heather Widdows and Iain Law. I would also like to thank the attendees of the Royal Institute of Philosophy seminar at Queen's University Belfast, and the 5th Interdisciplinary Workshop in the Philosophy of Medicine: Medical Knowledge, Medical Duties at King's College London for their invaluable input.
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