To the Editor: We wish to suggest an entirely
different interpretation of Dr Braddock and colleagues'1
dismal finding that physicians failed to meet a standard for informed consent
91% of the time. Rather than indicting physicians, these findings challenge
the standards themselves.
In recent decades, studies like those of Braddock et al have established
that the practice of informed consent is far removed from its theory. Meanwhile,
ethicists have crept toward what could be called mandatory autonomy—the
view that patients should make their own decisions whether they want to or
not.2 In other words, ethicists have increasingly
made the standards for informed consent more stringent even as empiricists
have increasingly shown how rarely they are met.
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