Climate Change Project

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Changing Values

Patients expressed their dissatisfaction with paternalism through lawsuits. In a small number of cases in the 1970s, physicians were sued for obtaining consent without informing patients of the risks of the proposed treatments. In almost every one of these cases, the failure to consult with the patient properly was only one facet of substandard care. A few courts held that a patient was entitled to be informed of the risks of treatment as part of the consent process. These opinions were seized upon by legal scholars, who then fashioned the theory of informed consent to medical care.

As more courts began to recognize a patient's legal right to be informed about the risks of treatment, this was transformed into an individual liberties issue. Physicians who did not inform patients adequately have been accused of oppressing their patients. This legal view of informed consent as a liberty issue created a bitter dispute over the role of the physician. Physicians felt that their integrity was being challenged over their good-faith attempts to shield patients from unpleasant medical information. The courts, despite much language about the special relationship between physicians and patients, have inexorably moved to the position that physicians who assume the right to make decisions for their patients also assume the consequences of those decisions.

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