Medical ethics and informed consent in invasive medical procedures

The issue of what is required of physicians in communicating to patients the risks involved in invasive medical procedures is discussed from the perspectives of the court, the ethicist, and the patient. Courts in the United States judge the adequacy of this communication on the basis of information disclosure, although they differ as to whether physicians must meet the professional standard or the reasonable-person standard. Ethicists emphasize a patient-centered standard, as well as the concept of substantial understanding. A study designed to elicit the patient’s perspective found that most patients prefer that decision-making be shared by physician and patient, that patients want risk information, and that the largest number of patients prefer that physicians use words rather than numbers to describe risk. However, the very wide range in patient understanding of such terms as probable or possible raises the question of whether using such terms achieves substantial patient understanding of risk.