University of Colorado Boulder professor explores new informed consent model
Pamela Lomelino, a University of Colorado Boulder professor, discussed a new model to approach informed consent when she spoke on campus last week.
Lomelino presented her paper, “Reasons to Prefer a Consent-as-Relational-Autonomy Model of Informed Consent,” to roughly 10 professors and students. Autonomy, or autonomous choice, is the concept of making choices based on one’s beliefs and values.
The model of consent-as-relational-autonomy supports mechanisms to help patients identify “internalized oppression” and further develop autonomy skills.
Lomelino said her method overcomes problems in other methods, such as consent-as-autonomy and consent-as-authority-and-trust, which “makes for a more feasible solution.”
The consent-as-autonomy model views the patient as a voluntary agent, according to Lomelino. In this theory, patients depend on doctors, who are in dominant societal groups, Lomelino said.
In the consent-as-authority-and-trust method, which was proposed by Joan Tronto, patients grant authority to make decisions to medical practitioners. This occurs, Lomelino said, when patients allow doctors to choose their medical system. To do so, patients must trust the doctor and the large healthcare system as a whole.
Consent-as-authority-and-trust should foster trust, Lomelino said, and doctors should be inspired to make decisions in the best interest of their patients. Patients, in turn, must feel assured the healthcare system is not sexist or racist.
Problems Lomelino sees in consent-as-authority-and-trust include too much trust, which causes patients to opt out of dialogue.
Lomelino cited historically unethical treatment practices, such as the Tuskegee syphilis trials, which tracked the progression of syphilis in black males, who believed they were receiving free health care, as reasons not to use the consent-as-authority-and-trust model.
Such medical atrocities lead to “general distrust of the medical community,” according to Lomelino.
To change current informed consent policies to her model, Lomelino suggested beginning with medical schools and training.
Given the right training, Lomelino said she thinks change will be seen. Additionally, Lomelino said the training of doctors with patients also needs to be addressed.
Filed Under: Philosophy