June 1988

Two Models of Implementing Informed Consent

Author Affiliations

From the Western Psychiatric Institute and Clinic, Pittsburgh, and the University of Pittsburgh Center for Medical Ethics (Drs Lidz and Meisel) and the Department of Psychiatry, University of Massachusetts Medical Center, Worcester (Dr Appelbaum).

Arch Intern Med. 1988;148(6):1385-1389. doi:10.1001/archinte.1988.00380060149027

• The doctrine of informed consent has been controversial since its inception. In spite of the professed ideal of improving physician-patient communication, many commentators have argued that it interferes with the relationship. However, the problem may not be the doctrine itself but rather the manner in which it is usually implemented. This article describes two different ways in which informed consent can be implemented. The event model treats informed consent as a procedure to be performed once in each treatment course, which must cover all legal elements at that time. The process model, in contrast, tries to integrate informing the patient into the continuing dialogue between physician and patient that is a routine part of diagnosis and treatment. We suggest that the process model has many benefits.

(Arch Intern Med 1988;148:1385-1389)