The short 'Informed Consent Requires Understanding: Complete Disclosure Is Not Enough' by Thaddeus Mason Pope in (2019) 19(5)
American Journal of Bioethics 27
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Beskow and Weinfurt tackle one of the most important yet under-examined issues in bioethics: the relationship between clinician disclosure and non-clinician understanding. They explore this relationship in the research ethics context, addressing four key questions. First, do research subjects understand basic aspects of the studies in which they are enrolled? Second, should we set minimum thresholds for research subject comprehension? Third, how and where should we set those minimum thresholds? Fourth, what consequences should we impose when subjects do not meet the minimum thresholds?
These are important inquiries for research ethics and human rights. But they are even more critical in the treatment context. Remarkably, we are not yet asking, much less answering, these questions about patients making decisions among treatment options. For example, a member of Beskow and Weinfurt’s multidisciplinary expert panel observes: “We don’t do comprehension testing anywhere else in medicine, so I don’t know why we’d do it here.” The panelist is right. There should be symmetry and harmony in how we treat understanding in the research and treatment contexts. In the following, I extend Beskow and Weinfurt’s four questions to address the proper role of comprehension in clinical informed consent.
