Informed consent

“Informed consent has provided a wonderfully portable and efficient means for approving the acceptance of medical care in a highly segmented and specialized medical system. The power to give informed consent today moves along with patients through medical institutions. It is portable. Specialized physicians who meet patients along their paths through the sites of care can make agreements about procedures quickly and serially. . . .Approval for care in mid-century medicine, although unburdened by formal procedures, may actually have been more cautious. Care had ideally to be coordinated through existing medical relationships with a single physician. Such arrangements posed a challenge to elaborate networks of specialized practitioners working in segmented institutional niches. . . . Informed consent narrowed decision-making powers efficiently to the individual patient. Any physician could be involved in a given instance of consent.. In addition, the patient’s family could often be efficiently dropped form the group needed to approve care. The older paternalistic model, in contrast, required coordination with the patient’s family” (Crenner II, 228-229, cf. 248)