Informed consent and patient decision making: two decades of research

Abstract

Patient consent to medical treatment has been a subject of concern within the United States professional communities for over two decades. This paper traces the development of research literature on patient decision making and informed consent to medical treatment in three fields of research: medicine, law and the social sciences. A general model for stages in the development of scientific specialties is applied as a test for the development of informed consent as a specialty interest in each research field. Results indicate a relatively advanced stage of development within medicine and law. Research in the social science disciplines tend to lag behind in terms of cumulative number of publications. In addition, social science research which is potentially relevant to the ethical and policy issues of consent in medical treatment appears to lack a clear programmatic thrust, with little attention given to the policy implications of the work. In contrast, the medical and legal literatures indicate a direct concern with social policy and reflect attempts on the part of physicians and lawyers to influence the policy making process.

KIE: Kaufmann examines the literature of medicine, law, and the social sciences to trace the development of interest in the issue of patient consent to medical treatment and experimentation. She applies a general model for the growth of scientific specialties to assess the level of research interest in informed consent as a subspecialty within each discipline, and describes how each discipline has approached the subject. She concludes that the more abundant medical and legal literature is further developed and reflects a direct concern with social policy, while the sparser social science literature is relatively undeveloped and has paid little heed to the ethical and policy implications of patient decision making.