INTRODUCTION: TWO MODELS OF INFORMED CONSENT

In Chapter 1 we argued that current thinking about informed consent, its justification, scope and standards, is problematic in a number of ways. We suggested that it would be profitable to ‘rethink’ informed consent. In Chapters 2 and 3 we explored two distinct models of information and communication. These models, in turn, support distinct approaches to informed consent. We shall argue in this chapter that although each model supports an account of the justification, the scope and the standards for informed consent, the conceptions of informed consent that emerge from these models differ in important ways. These differences have powerful implications for biomedical practice. By making explicit two different conceptions of informed consent, we pave the way for ‘rethinking’ informed consent in this chapter. In the chapters to follow we then shift from general and abstract theorising about communication and consent to a number of specific and concrete issues where informed consent is of key ethical importance.

The ‘standard’ way of thinking and talking about information and communication is, we suggested, the conduit/container model. When information is discussed in terms of the conduit/container model, it is thought of in abstraction from agents and from the speech acts by which they communicate. When we rely on this model, we think of information as ‘flowing’ or being ‘transferred’ between agents, who are thought of quite abstractly as ‘originating’ or ‘receiving’ messages. The message or content is highlighted, but the act of communicating is hidden.