Informed Consent
Self-determination, the concept that "every adult of sound mind has the right to decide what shall be done with his own body," is the foundation of the legal and ethical doctrine of informed consent. The process of informed consent should grow out of discussion between the patient and doctor. The patient asks questions about his condition and treatment options, and the doctor shares facts and insights along with support and advice. When a person's decision regarding treatment is based on information about risks, benefits, and alternative treatments gained from discussion with a doctor and incorporates the person's preferences, consent or refusal is said to be informed and is ethically valid and legally binding. All states require that such consent precede medical intervention.
Along with the right of informed consent comes the right of informed refusal. A decision to refuse treatment--even if puzzling--does not mean that a person is incompetent. In many cases, however, a person refuses treatment based on misunderstanding or lack of trust. A refusal of care should prompt the doctor to initiate further discussion. Doctors are ethically bound to encourage acceptance of the therapeutic recommendation judged to be in the person's best interest. Nevertheless, a person's refusal of treatment is not considered to be attempted suicide, nor is the doctor's compliance with the person's wishes considered physician-assisted suicide. Rather, the subsequent death is considered to be a natural consequence of the disease process itself.
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