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Theory of Informed Consent

Faden and Beauchamp's 1986 work A History and Theory of Informed Consent is a primary source for informed consent theory within the legal and medical fields. It explores two foundations in moral theory for informed consent: one describing an autonomous authorisation action by a subject, incorporating the concepts of understanding, noncontrol (voluntariness), and intention; and the other, effective consent, decided within a set of rules in public policy, with such concepts as disclosure and competence. These general concepts of understanding, noncontrol, disclosure, and competence have been, as we have seen, readily incorporated into the general ethical theory literature in medical and legal fields, and other related fields such as behavioural sciences. They have also been used as the basis for discussion about informed consent within other fields, including information technology [Friedman & Howe, 2002], which will be discussed in Chapter 3. The use of this book in particular as the basis for the examination of informed consent theory is grounded in the fact that almost all of the literature on informed consent in information technology refers back to Faden and Beauchamp for the theory used in developing informed consent practice [Brownsword, 2008,Friedman & Howe, 2002]1.2. I also look at some other primary sources for informed consent theory, but due to the sparseness of the literature on informed consent in IT I determined it best to examine the theories appropriated for the field. My main concern is outlining these appropriated theories as they relate to the practice, and determining whether they are useful and relevant for establishing reasonable informed consent in information technology. Arguing the particulars of the theories from first principles is therefore not within my scope, especially highly contentious topics, such as intention and understanding, where there is widespread disagreement within philosophy of mind, psychology, and other areas. Thus I have focussed on the relevant topics, namely the theories themselves, the theories' establishment of applicable concepts, and their application to the medical, legal, and information technology fields.

I am particularly interested in Faden and Beauchamp's account of informed consent because not only does it form the basis for most of the literature in informed consent theory and practice, but the effective consent model is closest to that actually used in information technology procedures. I am not interested in arguing against Faden and Beauchamp's theory as it applies to medical and clinical medical situations. I wish instead to establish that this theory is not appropriate for information technology use, both because of its grounding in autonomy (see section 1.2.1) and the difficulty of applying that to information technology situations, and because it allows for too much leeway in its requirements for sufficiency in areas such as understanding (see section 1.2.1).

Faden and Beauchamp begin by first exploring the idea of autonomy and how it underpins the idea of informed consent; they then discuss the main ethical concepts: intention, understanding, and noncontrol. These concepts are tied together to form the autonomous action part of the authorisation, and it is this act that constitutes their ``first sense'' of informed consent, that of informed consent as an autonomous authorisation action.



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Catherine Flick 2010-02-03