Informed Consent: The Great Unknown

· November 23, 2018

Informed consent is one of the primary tools psychologists use to put their professional ethics into practice. You could think of it as a two-way dialogue between the patient and the healthcare provider. During this dialogue, they discuss the benefits and possible disadvantages of a treatment or psychological test.

Informed consent is consent which is freely and voluntarily given by the subject for actions taken related to their health after having received the proper and complete information and considered all of their options.

The post-war origin of informed consent

You may have heard about Josef Mengele, known as Dr. Mengele or “Angel of Death”. This German doctor became famous due to his sadism and terrible cruelty. A member of the Nazi party, Dr. Mengele experimented on human subjects for many years. He was especially interested in newborn twins. He used procedures that were painful and caused irreversible physical and psychological harm. Some of his subjects died as a result of his experiments.

A patient signing an informed consent.

Informed consent had its beginnings after the Second World War (second half of the 20th century). One particularly strong factor in the origin of informed consent is the Nuremberg trials. During the Nuremberg trials, a large number of directors, government officials, and collaborators were accused and found guilty of war crimes.

In 1947, people began to consider consent as a basic pillar of scientific research with human subjects. In this historical context, two North American doctors come into the scene. Leo Alexander and Andrew Conway Ivy came up with a ten-point memorandum about ethical norms called “Permissible Medical Experiments”. Later on, it became the Nuremberg Code. Voluntary consent was essentially the very first point of the code.

The content of informed consent

The psychologist’s obligation is to inform the patient in a true, clear, accurate, and complete way about the study, intervention, treatment, or psychological research that the patient will participate in. But what exactly does the patient have the right to know?

  • Evaluation of the disorder: Informing the patient about the diagnosis of the illness or condition.
  • Nature and duration of the proposed treatment: Number of sessions, follow up, and evaluation.
  • Possible risks, side-effects, and problems: The most probable risks based on trustworthy scientific research.
  • Expected benefits.
  • Possible alternative treatments. 
  • These days, psychologists also tend to add a sixth element, which is contractual issues. This refers to payment, payment plans, confidentiality agreements, and the participation of third parties.

Conditions of informed consent

Informed consent is the medical-psychological procedure that seeks to respect the principle of patient autonomy and dignity. It honors the duty to respect everyone as individuals and to respect their preferences regarding medical treatment. There are four requirements a person must meet to draw up a valid informed consent document:

  • Willingness: The psychologist gets consent without external pressure. In other words, the patient must give consent freely and voluntarily, without any pressure, force, fraud, deceit, persuasion, manipulation, or any other type of coercion. The psychologist must give the patient enough time to reflect, consult, and decide.
  • Ability: The individual must have the ability to make decisions. They must have the legal ability to give consent for themselves. There are situations where people aren’t able to give consent for themselves, like in cases of people who are underage, unconscious, or have certain mental health problems.
  • Information: The user has to have enough information about the treatment or study to be able to make a reasonable decision.
  • Comprehension: It’s the psychologist’s job to make sure that the patient understands all of the information. It’s the patient’s right to fully understand all of the information.
A worried female patient with a healthcare provider.

Written and verbal consent

It’s crucial that the psychologist reads the document aloud and that the patient reads it. The patient should feel completely informed so they can freely approve the process. In the case of written communication, the process ends when the patient signs the informed consent document. This signature confirms that the patient is on board with everything that the healthcare provider communicated.

In conclusion, you can see that informed consent is fundamental to psychological practice. What’s more, if you fail to get informed consent, you could be charged with psychological malpractice or negligence.