Court Viewpoints and Medical Decision Making

Twenty-five years of appellate court decisions about informed consent in three influential states were examined to address four issues: 1) the criteria used to define adequate informed consent; 2) trends in court decisions; 3) parallels between court decision making and decision analysis; 4) the contribution of decision analytic concepts to defining "reasonable" medical informed consent. Court standards have evolved in three phases: the "medical community" standard before 1972, the "reasonable person" standard since 1972, and recent inroads toward developing an "individual preference" standard. The latter two standards form the current basis for deciding whether a patient has been adequately informed. Decision analysis offers a framework for communication about medical outcomes and probabilities, and meth ods for assessing preferences. Jurists and physicians should consider whether the legal system should adopt a decision analytic perspective in the doctrine of informed consent. Researchers should address issues raised by use of decision analysis for communication between the physician and the patient. Key words: medical ethics; patient-physician rela tionship; medical informed consent; medical risk; patient preference; legal (court) decision; professional standards; reasonable man; malpractice; negligence. (Med Decis Making 6:224- 230, 1986)