Informed Consent in Russia: Misuse and Abuse

Informed Consent in Russia: Misuse and Abuse
Irina S. Mylnikova
Medical Ethics, 31 March 2021
Open Access
Abstract
Even T. Beauchamp and J. Childress, the founders of ethical principlism, noted that in practice the principles of bioethics, which they might have formulated, may conflict, and adherence to one principle may violate the other. To date, the conflict between the principle of autonomy and the doctrine of informed consent, and the principle of vulnerability formulated ten years later (one of the principles introduced by P. Kemp) and the necessity to take care of the patient is one of the major irreconcilable conflicts. This conflict is especially severe in Russia, where the informed consent was immediately enshrined as a statutory provision without prior discussion with the medical and non-medical communities, which gave rise to numerous opportunities for misuse and abuse, and stepped up the bureaucratic pressure both on patients, who became more vulnerable, and the physicians, who started using the informed consent to their advantage, sometimes being openly market oriented. The growth of mutual mistrust, sometimes reaching the level of aggression, forces one to find a remedy for this situation. In the author’s view, this requires revision of the patient’s autonomy concept and the concept of informed consent considering the acceptance of the patient’s intense vulnerability and the patient’s need for the healthcare specialists’ (physicians and nurses) personal involvement and care. It may be helpful to consult the writings of the ethics of care, feminist ethics and other ethical trends representation, as well as the results of field research aimed to combine principles of freedom and patient care in a given situation.