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March 8, 1993

Talk About Not Talking

Author Affiliations

Division of the Medical Humanities University of Rochester School of Medicine Strong Memorial Hospital 601 Elmwood Ave, Box 676 Rochester, NY 14642

Arch Intern Med. 1993;153(5):557-558. doi:10.1001/archinte.1993.00410050005001

ANY CONTEMPORARY discussion of medical treatment decisions necessarily requires consideration of the doctrine of informed consent. Its introduction into the doctor-patient relationship caused some stirs and generated considerable misunderstanding. Consider, for example, a 1977 letter to the editors of The New England Journal of Medicine.1 The authors described two cases in which they speculated that heart attacks were caused by [ill]e infliction of unwanted medical information. Blaming [ill]e informed consent principle and their fear of being sued, [ill]e authors lamented that "legal reasons" were forcing them persist with a potentially frightening dissertation," even [ill]n their patients said "I don't want to know" or "Don't [ill]me."1 Thankfully, understanding of the informed con[ill]t doctrine has evolved to a higher plane, including cor[ill]tion of the two misconceptions evident in that letter. [ill]w it is accepted that there is a therapeutic privilege [ill]mitting nondisclosure when the doctor believes the [ill]rmation will be

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