Informed Consent and Shared Decision Making
Informed consent given by a person with capacity is the dominant metaphor used to describe clinical decision making.
The focus is on the provision of information and who has the power to make decisions; the patient, the substitute decision maker (if the patient lacks capacity) or the doctor if the other two options are absent. This is a poor descriptor of everyday practice which is based around developing shared goals of care and an agreed management plan. It is also poor at dealing with hard cases.
I will illustrate this with a number of cases and make suggestions as to how the law should be amended.
Associate Professor Ben Gray retired 2 years ago from working as a GP in a high needs practice after 27 years. He has convened the undergraduate teaching in Professional Development, Ethics and Health Law for the past 16 years and has completed an MBHL from Otago. He has a particular interest in cross cultural care and the intersection between cultural competence bioethics and health law.