Medical Nemesis

 

“To protect us against doctors there is no law against ignorance, no example of capital punishment. Doctors learn at our risk, they experiment and kill with sovereign impunity, in fact the doctor is the only one who may kill. They go further and make the patient responsible: they blame him who has succumbed.”

— Plinius Secundus, Naturalis Historia

The trouble with informed consent is that it is not educated consent. Let us assume that the experimental subject, whether a patient, a volunteer, or otherwise enlisted, is exposed to a completely honest array of factual detail. He is told of the medical uncertainty that exists and that must be resolved by research endeavors, of the time and discomfort involved, and of the tiny percentage risk of some serious consequences of the test procedure. He is also reassured of his rights and given a formal, quasilegal statement to read. No exculpatory language is used. With his written signature, the subject then caps the transaction, and whether he sees himself as a heroic martyr for the sake of mankind, or as a reluctant guinea pig dragooned for the benefit of science, or whether, perhaps, he is merely bewildered, he obviously has given his “informed consent.” Because established routines have been scrupulously observed, the doctor, the lawyer, and the ethicist are content.