Between the reasonable and the particular: Deflating autonomy in the legal regulation of informed consent to medical treatment

The law of informed consent to medical treatment has recently been extensively overhauled in England. The 2015 Montgomery judgment has done away with the long-held position that the information to be disclosed by doctors when obtaining valid consent from patients should be determined on the basis of...

Full description

Bibliographic Details
Main Authors: Dunn, M, Fulford, K, Herring, J, Handa, A
Format: Journal article
Published: Springer Verlag 2018
_version_ 1797080580361289728
author Dunn, M
Fulford, K
Herring, J
Handa, A
author_facet Dunn, M
Fulford, K
Herring, J
Handa, A
author_sort Dunn, M
collection OXFORD
description The law of informed consent to medical treatment has recently been extensively overhauled in England. The 2015 Montgomery judgment has done away with the long-held position that the information to be disclosed by doctors when obtaining valid consent from patients should be determined on the basis of what a reasonable body of medical opinion agree ought to be disclosed in the circumstances. The UK Supreme Court concluded that the information that is material to a patient’s decision should instead be judged by reference to a new two-limbed test founded on the notions of the ‘reasonable person’ and the ‘particular patient’. The rationale outlined in Montgomery for this new test of materiality, and academic comment on the ruling’s significance, has focused on the central ethical importance that the law now (rightfully) accords to respect for patient autonomy in the process of obtaining consent from patients. In this paper, we dispute the claim that the new test of materiality articulated in Montgomery equates with respect for autonomy being given primacy in re-shaping the development of the law in this area. We also defend this position, arguing that our revised interpretation of Montgomery’s significance does not equate with a failure by the courts to give due legal consideration to what is owed to patients as autonomous decision-makers in the consent process. Instead, Montgomery correctly implies that doctors are ethically (and legally) obliged to attend to a number of relevant ethical considerations in framing decisions about consent to treatment, which include subtle interpretations of the values of autonomy and well-being. Doctors should give appropriate consideration to how these values are fleshed out and balanced in context in order to specify precisely what information ought to be disclosed to a patient as a requirement of obtaining consent, and as a core component of shared decision-making within medical encounters more generally.
first_indexed 2024-03-07T01:02:08Z
format Journal article
id oxford-uuid:8a14fc32-2acf-4c7f-924f-f51d0b7c1f3f
institution University of Oxford
last_indexed 2024-03-07T01:02:08Z
publishDate 2018
publisher Springer Verlag
record_format dspace
spelling oxford-uuid:8a14fc32-2acf-4c7f-924f-f51d0b7c1f3f2022-03-26T22:29:03ZBetween the reasonable and the particular: Deflating autonomy in the legal regulation of informed consent to medical treatmentJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:8a14fc32-2acf-4c7f-924f-f51d0b7c1f3fSymplectic Elements at OxfordSpringer Verlag2018Dunn, MFulford, KHerring, JHanda, AThe law of informed consent to medical treatment has recently been extensively overhauled in England. The 2015 Montgomery judgment has done away with the long-held position that the information to be disclosed by doctors when obtaining valid consent from patients should be determined on the basis of what a reasonable body of medical opinion agree ought to be disclosed in the circumstances. The UK Supreme Court concluded that the information that is material to a patient’s decision should instead be judged by reference to a new two-limbed test founded on the notions of the ‘reasonable person’ and the ‘particular patient’. The rationale outlined in Montgomery for this new test of materiality, and academic comment on the ruling’s significance, has focused on the central ethical importance that the law now (rightfully) accords to respect for patient autonomy in the process of obtaining consent from patients. In this paper, we dispute the claim that the new test of materiality articulated in Montgomery equates with respect for autonomy being given primacy in re-shaping the development of the law in this area. We also defend this position, arguing that our revised interpretation of Montgomery’s significance does not equate with a failure by the courts to give due legal consideration to what is owed to patients as autonomous decision-makers in the consent process. Instead, Montgomery correctly implies that doctors are ethically (and legally) obliged to attend to a number of relevant ethical considerations in framing decisions about consent to treatment, which include subtle interpretations of the values of autonomy and well-being. Doctors should give appropriate consideration to how these values are fleshed out and balanced in context in order to specify precisely what information ought to be disclosed to a patient as a requirement of obtaining consent, and as a core component of shared decision-making within medical encounters more generally.
spellingShingle Dunn, M
Fulford, K
Herring, J
Handa, A
Between the reasonable and the particular: Deflating autonomy in the legal regulation of informed consent to medical treatment
title Between the reasonable and the particular: Deflating autonomy in the legal regulation of informed consent to medical treatment
title_full Between the reasonable and the particular: Deflating autonomy in the legal regulation of informed consent to medical treatment
title_fullStr Between the reasonable and the particular: Deflating autonomy in the legal regulation of informed consent to medical treatment
title_full_unstemmed Between the reasonable and the particular: Deflating autonomy in the legal regulation of informed consent to medical treatment
title_short Between the reasonable and the particular: Deflating autonomy in the legal regulation of informed consent to medical treatment
title_sort between the reasonable and the particular deflating autonomy in the legal regulation of informed consent to medical treatment
work_keys_str_mv AT dunnm betweenthereasonableandtheparticulardeflatingautonomyinthelegalregulationofinformedconsenttomedicaltreatment
AT fulfordk betweenthereasonableandtheparticulardeflatingautonomyinthelegalregulationofinformedconsenttomedicaltreatment
AT herringj betweenthereasonableandtheparticulardeflatingautonomyinthelegalregulationofinformedconsenttomedicaltreatment
AT handaa betweenthereasonableandtheparticulardeflatingautonomyinthelegalregulationofinformedconsenttomedicaltreatment