Consent to medical care can be truly voluntary only when it is reasonable to
reject the care. Certain religious groups aside, a patient can be assumed to
accept the risks of lifesaving care. The law recognizes this in its requirement
that a patient convince the jury that he or she would have forgone the
treatment had the risk in question been made clear. The more clearly
necessary a treatment is, the less meaningful is the idea of informed consent.
Yet even in life-threatening situations, voluntariness can be an issue if there is
more than one appropriate treatment. The patient might not reasonably reject
all treatment but may justifiably argue that he or she might have chosen a
Voluntariness becomes a legal issue if the physician coerces the patient into
accepting a treatment for which there are acceptable alternatives. This coercion
may be explicit—telling the patient that he or she will die without the proposed
treatment at once—or implicit—ignoring the discussion of alternatives or
financial intimidation. Physicians who cooperate with third-party payers to limit
patients’ treatment options undermine the voluntariness of patient consent.
They should not be surprised if a court determines that this renders the
patient’s informed consent invalid.