Informed consent, as the courts define it, is the patient's right to know, before agreeing to a procedure, what the procedure entails — the hazards, the possible complications, and expected results of the treatment. The patient must understand any reasonable alternatives to the proposed procedure, including, in most cases, the results that can be predicted from nontreatment. The choice among alternative risks involves value judgments falling outside the scope of medical decision-making, including the patient's views on social, economic, and other personal factors of which health professionals cannot possibly be aware.

The negotiations necessary to obtain the patient's informed consent are the responsibility of the person who will perform the procedure. If a physician is in charge, the physician may delegate the discussion to another but retains the legal responsibility to make sure the patient understands.

Hospitals are often busy places, and in the course of routine procedure many patients have their privacy violated. While patients have a right to privacy, sometimes called a “right to be let alone,” courts will not generally permit a patient to recover money damages unless it can be shown that the invasion was intentional and would be objectionable to a person of ordinary sensibilities. Two cases from the State of Maine illustrate the issues involved. The first is a 1976 case in which a physician, who had operated on a patient twice for cancer of the larynx, was taking a series of photographs of the patient's neck. On the day the patient died, the physician and a nurse came to the patient's room. The physician (or the nurse, at his direction) raised the dying patient's head and placed some blue operating room toweling under it for color contrast and proceeded to take photographs.

The nursing home nurses were faced with a troubling problem. An 87 year old woman, who had been a resident of the home for several years, had gradually become disoriented, confused, and nearly unable to communicate. Nursing care for this otherwise healthy woman continued as always — monitoring and maintaining her medical status with a necessary increase in physical care as her own self-care ability diminished. The problem was the woman's son: he was demanding to see his mother's chart because he believed that she had cancer and that this was being concealed from him. What should the nurses do?

The issue is complex and can best be examined in stages. The first question is: does the son have a legal right to see his mother's records? The answer is that in no state does a patient's son or other relative have an automatic legal right, by virtue of his relationship to the patient, to see an adult patient's medical record. Often, particularly with nursing home patients, a relative signs an agreement to assume financial responsibility for expenses incurred by a patient.