Informed consent: Patient autonomy in medical decision making

“Autonomy” is derived from the Greek words “autos” and “nomos,” which mean “self “and “law,” respectively. A core principle in contemporary medicine, autonomy has been adopted in reference to practices such as informed consent and shared decision making. Writings like the Nuremberg code and the Declaration of Helsinki highlight the significance of voluntary consent in medical decision making.

Medicine as a field prioritizes patient autonomy, deeming it ethically and morally necessary for the patient to make all medical decisions. Additionally, in the United States, patient rights are protected by law, which includes both the right to accept or refuse medical treatment as long as the patient is capable of doing so.

To truly permit a patient to decisively communicate their perspective requires a comprehensive understanding of both current conditions and knowledge of the consequences of each possible option. This is where informed consent is of crucial importance. In countries like China, family or clan interests take priority, whereas Western culture advocates for individualism and personal informed consent.

In theory, all practicing physicians should be ensuring that informed consent is acquired from a patient prior to any procedures conducted. However, this is not always the case when there are systemic barriers in place that inhibit patient understanding.

In the United States, there is a diverse range of patients – all from different backgrounds with distinct beliefs. In Houston alone, there are at least 145 languages spoken by community residents, ranking Greater Houston as the most ethnically diverse metropolitan area in the country. With such an abundance of diversity, it’s crucial that the medical field takes this into account when communicating with complex vocabulary consisting of medical jargon.

Oftentimes, such vigilance is sacrificed due to the amount of time and effort it requires to translate medical terminology into easily understood language. Traditionally, consent forms are standardized and written with a particularly high level of health literacy that the average person would struggle to comprehend.

An empirical study further notes that patients often demonstrate limited understanding when it comes to their level of comprehension of informed consent. With a lack of complete understanding, patients cannot truly make informed decisions as they are unaware of the risks associated with a particular procedure.

Making decisions — especially those that can completely transform patients’ futures — can be quite daunting. Advocating for informed consent and enhanced physician-patient communication may provide a familiar level of comfort that is necessary to protect patient autonomy.

-By Midhat Jafry, summer intern in the Center for Medical Ethics and Health Policy at Baylor College of Medicine, and a junior pursuing a Bachelor’s of Science in biology and liberal studies at the University of Houston.