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Consent for Intensive Care: Public and Political Expectations vs. Conceptual and Practical Hurdles 

Consent for Intensive Care: Public and Political Expectations vs. Conceptual and Practical Hurdles
Chapter:
Consent for Intensive Care: Public and Political Expectations vs. Conceptual and Practical Hurdles
Author(s):

Dominic Bell

DOI:
10.1093/med/9780198817161.003.0001
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date: 17 April 2021

Consent, as the embodiment of respect for autonomy, is considered fundamental to the patient–doctor relationship. The nature of the consent process, as defined by the regulatory bodies and the law, starts with the provision of all information that the patient might consider significant. There is no suggestion that any element of medical care should not be based on these contemporary principles. Intensive care is, however, hard to define in terms of nature, personnel, impact, and outcome, which correspondingly compromises the core foundations of consent. While initiatives are under way to proactively explore and document values and beliefs that might inform subsequent decision making at times when capacity is lost, it is difficult to anticipate that standards of consent applicable to defined medical or surgical treatments will ever be realizable for intensive care. There needs to be broader public, and indeed professional, understanding of the nature and goals of intensive care if all relevant parties are to be confident that the best interests of the individual patient are being met when offering, withholding, delivering, or withdrawing life-sustaining medical treatment.

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