This chapter looks at the background to the theories of informed consent, examining in particular the principle of autonomy, and why it is considered so important by informed consent theorists. It will also provide analysis of the traditional theory of informed consent from a legal and medical perspective, concentrating on the ideas of informed consent as autonomous authorisations and effective consent (as described by [Faden & Beauchamp, 1986], and discussed in section 1.2), as well as discussing the criticisms put forward by Manson and O'Neill (2007).
Manson and O'Neill's criticisms of Faden and Beauchamp's theory are particularly important to this thesis, because it is through these and the case studies of Chapter 2 that I will show that the Faden and Beauchamp theory is inappropriate for use in information technology. I will ultimately base my own theory for informed consent in information technology on that of Manson and O'Neill (2007), which I will outline in this chapter, and further develop in Chapter 3.
Theory of informed consent has traditionally focussed on the core value being the autonomous decision of the person involved, whether patient, research subject, contract signer, or any other role that requires consent. The concept of autonomy is a central doctrine of the informed consent theories I explore in this thesis [Faden & Beauchamp, 1986,Appelbaum et al., 1987]. There are, however, some criticisms of the use of autonomy as the base principle for justifying the need for informed consent, and alternative proposals for its justification [Manson & O'Neill, 2007], as well as dialogue and criticisms that stem from these [Brownsword, 2004,DuBois, 2007,Spriggs, 2007], which will also be discussed in this chapter.
Although the traditional theories certainly have strength, and have been shown to establish good procedures and policy in the medical field, my argument in the following chapters is not so much with the theories themselves in medical ethics as with their applicability to information technology settings. There are parts of some theories that are quite applicable (such as parts of the Faden and Beauchamp theory concerning understanding and disclosure, discussed in sections 1.2.1 and 1.2.2), but better alternatives are available for application to information technology.
One of the main problems encountered in information technology situations is that these traditional theories have been poorly applied, or that the focus has been on dealing with the wrong sorts of concepts. As I will show later, vendors pick and choose parts of theories, branding their amalgamation ``informed consent'', while ignoring other important parts of the theory; or realise that adapting the entire theory into an information technology situation is problematic, and so restricting the informed consent principles to those able to be applied easily. Thus I identify the need for policies that tailor theories of informed consent to information technology in a better way. The sort of theory required in IT is one that concerns itself with the actual situations computer users find themselves in when consent is sought of them. It needs to be able to be easily integrated into the design process allowing informed consent to be a mechanism that enables the protection of other values, rather than an ad-hoc approach that concentrates on the consent-gaining as its main aim.
In developing this chapter, I focus on the problems of applying the traditional, autonomy-justified theories for informed consent to information technology situations. I particularly draw attention to the differences between the contexts of the medical and information technology fields in order to set the scene for establishing alternatives to the autonomy-based theories and, ultimately, a more appropriate theory for information technology situations in the subsequent chapters.