Performing informed consent in transgender medicine
Shuster SM
Social Science and Medicine, 3 March 2019; 226 pp 190-197
Abstract
Using in-depth interviews with 23 physical and mental healthcare providers and observations at transgender-specific healthcare conferences between 2012 and 2015, I examine how medical providers negotiate informed consent processes in their clinical encounters with trans patients. While a growing body of scholarship has examined informed consent in scientific research from the patient’s perspective, a gap remains in how informed consent is understood in clinical encounters, and from providers’ perspectives. I use the case of trans medicine, an emergent field of medicine that has not yet implemented standardized procedures or policies that shape providers’ decision-making. I demonstrate how many providers of trans medicine give voice to following informed consent, but fail to actually practice it in their work with trans patients. In performing informed consent, providers revert to a paternalistic model of care, which amplifies their medical authority while veiling power differentials in their clinical encounters and decision-making in trans medicine.

Predicting major mental illness: ethical and practical considerations
Stephen M. Lawrie, Sue Fletcher-Watson, Heather C. Whalley and Andrew M. McIntosh
British Journal of Psychiatry, 2019; 5(e30) pp 1–5
Summary
An increasing body of genetic and imaging research shows that it is becoming possible to forecast the onset of major psychiatric disorders such as depression and schizophrenia before people become ill with ever improving accuracy. Practical issues such as the optimal combination of clinical and biological variables are being addressed, but the application of predictive algorithms to individuals or in routine clinical settings have yet to be tested. The development of predictive methods in mental health comes with substantial ethical questions, including whether people wish to know their level of risk, as well as individual and societal attitudes to the potential adverse effects of data sharing, early diagnosis and treatment, which so far have been largely ignored. Preliminary data suggests that at least some people think predictive research is valuable and would take part in such studies, and some would welcome knowing the results. Future initiatives should systematically assess opinions and attitudes in conjunction with scientific and technical advances.

Crisis at the Pregnancy Center: Regulating PseudoClinics and Reclaiming Informed Consent
Teneille R. Brown
Yale Journal of Law & Feminism, 2019; 30(2)
Abstract
Crisis Pregnancy Centers (CPCs) adopt the look of medical practices-complete with workers in scrubs, ultrasound machines, and invasive physical exams-to deceive pregnant women into thinking they are being treated by licensed medical professionals. In reality, CPCs offer exclusively Bible- based, non-objective counseling. Numerous attempts to regulate CPCs have faced political roadblocks. Most recently, in NIFLA v. Becerra, the Supreme Court held that state efforts to require CPCs to disclose that they are not medically licensed are unconstitutional violations of CPCs’ First Amendment right to free speech. In the wake of that decision, pregnant women in crisis-a disproportionate percentage of whom are low-income women, minority women, or women in vulnerable or dangerous situations-continue to be subject to CPCs’ ideological marketing, masquerading as medical advice.