Informed Consent and Public Health

These flashcards cover key concepts from the lecture notes on informed consent, contrasting its application in clinical medicine versus public health, exploring its philosophical and practical limitations, and discussing the justification of compulsion for public goods.

What has been the primary focus of medical ethics over the past 25 years?

Clinical medicine and the treatment of individual patients.

How does public health provision fundamentally differ from individual medical provision regarding individual choice?

Public health provision is a public good provided for many, and its provision cannot be contingent on individual choice or informed consent.

According to the notes, what must public health ethics consider instead of solely focusing on informed consent?

The permissible limits of just compulsion for various types of public goods.

What conspicuous change has significantly altered medical ethics over the past 30 years?

A steadily increasing focus on informed consent, now usually taken as essential for ethical medical practice.

What are some common reasons cited for the ethical importance of informed consent?

Respecting persons, respecting the autonomy of persons, or providing assurance that patients are not deceived or coerced.

What frequently discussed range of problems arises when patients cannot give informed consent?

Patients may be too young, ill, disabled, or demented to grasp the necessary information, requiring treatment without their consent or relying on proxy consent.

What is identified as the 'most basic philosophical difficulty' with informed consent procedures?

Consent is a propositional attitude, meaning it's directed at a description, and propositional attitudes are opaque.

Why does the 'opacity' of propositional attitudes pose a problem for informed consent?

Patients may consent to an intervention as described but not be aware of or consent to other true descriptions or obvious effects, even if entailed by the initial description.

What two suggested improvements to informed consent procedures are mentioned as heightening difficulties?

Demanding all consent be explicit rather than implied, and specific rather than generic.

Why is it impossible to fully replace implied consent with explicit consent procedures?

Explicit consent always relies on background understandings that remain implicit, and no consent form can completely describe everything that will be done.

How do specific consent requirements negatively impact secondary data analysis and epidemiology?

They undermine these fields because many valuable research purposes could not have been anticipated at the time initial tissues/information were collected, making specific prior consent impossible.

Why can informed consent not be ethically required for the provision of public goods?

Because public goods like road safety or protection against infection cannot be tailored to individual choice, and 'ought implies can' – it's impossible to make them contingent on individual consent.

Which political philosopher and theory are referenced to discuss the justification of compulsion in public health?

John Stuart Mill's form of liberalism, particularly as developed in 'On Liberty.'

According to Mill's view, under what sole condition is interference with individual liberty (compulsion) warranted?

Self-protection, meaning it is permitted only where needed to prevent harm to others.

What is the Latin phrase mentioned that supports the idea that the welfare of the people is paramount in public health?

Salus populi suprema lex (The welfare of the people is the supreme law).