A Structurational Analysis of Informed Consent to Treatment: Societal Evolution, Contradiction, and Reproductions in Medical Practice

Abstract

Informed consent (IC) to treatment enables physician disclosures (e.g., risks, benefits) and shared decisions, and honors patient autonomy and bodily integrity. Unfortunately, litigation and rising physician malpractice insurance suggest a need to reexamine IC. To initiate this, problems plaguing prior studies of IC interaction—lack of discursive and theoretical perspectives, neglect of IC's sociohistorical context—must first be addressed. Structuration theory, which overcomes these problems, guided analyses of IC law, resulting in discovery of three sociohistorical systems of meaning or discourses representing interests that favor different groups' (physicians, states and administrative entities, patients) control of IC's meaning and ideal practice. The article then works toward blending IC's sociohistorical context with struggles in contemporary practice by reexamining the literature on IC interaction for (re)productions of these discourses.