Abstract

KIE: In 1984 the English Civil Court of Appeals in Sidaway v. Bethlem Royal Hospital rejected the American doctrine of informed consent, in which the measure of disclosure is based on the patient's need to know, and reasserted the British paternalistic concept based on standard medical practice. Annas analyzes the justices' reasoning and concludes that it was based primarily on misinformation concerning the effect of informed consent on the incidence of malpractice litigation in the U.S. and on a misunderstanding of how the concepts of duty and causation were applied in Canterbury v. Spence. He urges British physicians, even in the absence of a legal mandate, to obtain an informed consent that promotes autonomy and rational decision making and thus strengthens the physician patient relationship.