Barbara Noah, ‘The (Ir)Ationality of (Un)Informed Consent’

In this Article, the Author uses the analogy of life as a long airplane flight, with the takeoff at birth and the deceleration on the landing strip as one nears death. The question many will face at the final stage of deceleration is how long to receive therapy and life-prolonging treatment before death. The Author describes three approaches to mortality, all of which promote the autonomous wishes of the individual: to avoid suffering by curtailing the process of dying; to live as long as possible no matter what the physical or psychic cost; and to die at the optimal time, navigating the narrow gap between premature death and death after long suffering and exorbitant healthcare costs.

In the United States, patients utilize significant amounts of hospital-based resources at the end of life, often with little or no measurable benefit to the dying patient. The default model of life-sustaining care and continuing therapeutic treatment is provided, unless the patient goes through the emotionally and intellectually taxing effort of either a properly informed or a rather uninformed consent process and opts out. The Article discusses the idea that informed consent has its limits, but also avoiding the effort to achieve truly informed consent is an irrational choice because it risks serious negative outcomes for patients.

Noah, Barbara A, The (Ir)Ationality of (Un)Informed Consent (2016). Quinnipiac Law Review, Vol 34, p 691, 2016; Western New England University School of Law Legal Studies Research Paper No 16-11.

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