Towards a coherent model of informed consent : is there, and should there be, a coherent model of informed consent to surgery across medical ethics, medical professional regulation, and medical law? [DISSERTATION]

Towards a coherent model of informed consent : is there, and should there be, a coherent model of informed consent to surgery across medical ethics, medical professional regulation, and medical law? [DISSERTATION]
Louise Austin
University of Bristol, 2021; PhD Thesis
Abstract
Utilising the empirical ethics methodology and method of ‘reflexive balancing’ (RBL), this thesis asks: is there, or should there be, a coherent model of informed consent to surgery across medical ethics, medical professional regulation, and medical law? It concludes that whilst presently there is not a coherent model across these three areas, there should be, and a proposed model is outlined. In reaching this conclusion, the thesis draws upon ethical literature, the medical regulatory and legal standards of informed consent, and my empirical analysis of fitness to practice decisions and court judgments concerning informed consent in the context of surgery. Such a detailed analysis of these decisions and judgments has not been done before and this thesis, therefore, makes an original and significant contribution to existing scholarship. This contribution is developed further by the use of RBL to bring the data together to address the question the thesis asks. RBL has not previously been used to bring together medical ethics, medical professional regulation, and medical law. Chapter One sets out the methodology and methods underpinning the thesis. Chapters Two to Four illustrate there is not a coherent model of informed consent to surgery across medical ethics, medical professional regulation, and medical law. Chapters Five and Six set out the empirical analysis and Chapter Seven draws upon that analysis to develop a model of informed consent to surgery. RBL is then utilised to challenge that model, leading to a coherent model of informed consent to surgery across medical ethics, medical professional regulation, and medical law. This model enables autonomous choices about surgery, utilising objective and subjective perspectives in determining what information should be given to patients, and requiring understanding and reflection. The thesis concludes with recommendations for the model’s implementation, and for further research suggested by the thesis’ findings.

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