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March 1993

Informed Consent and Medical Ethics

Author Affiliations

From the Wilmer Ophthalmological Institute (Dr Finkelstein) and the Office of the General Counsel (Ms Smith), the Johns Hopkins Hospital, Baltimore, Md, and School of Hygiene and Public Health (Dr Faden), the Johns Hopkins University, Baltimore.

Arch Ophthalmol. 1993;111(3):324-326. doi:10.1001/archopht.1993.01090030042034

• Informed consent is based on a shared decision between physician and patient, with the physician understanding the relevant values of the patient and the patient understanding the nature of the disease and intervention, including risks and benefits. Informed consent has developed rapidly since it was introduced in the 1950s, reflecting recent changes in the practice of medicine that respect the increase of patient autonomy. The purpose of the written consent form is to document that a process of informed consent has taken place. It is generally agreed that all surgical as well as research procedures require written consent. For certain nonsurgical procedures, the decision regarding obtaining written consent will consider both the risk involved for the patient and the general community standard. Informed consent serves as an important symbol of a physician-patient relationship that adheres to the valued principles of medical ethics.

Schloendorff v New York Hospital, 211 NY 125 (1914).
Salgo v Leland Stanford, Jr, University Board of Trustees, 317 P2d 170 (Calif Ct Appeals 1957).
Military Tribunal I. Trials of War Criminals Before the Nuremberg Military Tribunals Under Control Council Law No. 10 . Washington, DC: US Government Printing Office; 1948.
The National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research. The Belmont Report: Ethical Principles and Guidelines for the Protection of Human Subjects of Research . Washington, DC: US Dept of Health, Education, and Welfare; 1978. DHEW publication (OS) 78-0012 (Appendix I, [OS] 78-0013; Appendix II, [OS] 78-0014).