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March 8, 1993

Talk About Not Talking

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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