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April 12, 1976

The Fiction of Informed Consent

Author Affiliations

From the Department of Surgery, Boston University School of Medicine, and the Thoracic Surgery Service, Newton-Wellesley Hospital, Newton Lower Falls, Mass.

JAMA. 1976;235(15):1579-1585. doi:10.1001/jama.1976.03260410035020

FEW FABRICATED concepts of recent vintage have achieved the currency, uncritical and ungrudging, of "informed consent." The term is so semantically felicitous, so easy to say, so straightforward and uncomplicated, that it must seem churlish indeed to suggest that it is a fraud. But Socrates said in Cratylus (Jowett [trans]): "He who first gave names and gave them according to his conception of the things which they signified; if his conception was erroneous, shall we not be deceived by him?"

It is perhaps thought-provoking to point out that those who write so knowingly of this "doctrine" are lawyers, who find it a convenient notion in medical malpractice suits; medical academicians, who are insulated from the realities of patient care by a host of underlings; or directors of research, who delegate the actual conduct of their experiments to assistants. No one, however, who is involved at the doctor-patient level, in either