City Research Online

The consent process: enabling or disabling patients’ active participation?

Doherty, C., Stavropoulou, C. & Saunders, M. (2015). The consent process: enabling or disabling patients’ active participation?. Health, 21(2), pp. 205-222. doi: 10.1177/1363459315611870


Standards expected by doctors’ regulatory bodies in respect of the process of consent to treatment have arguably sought to restructure the nature of the doctor-patient relationship from one of paternalism to that of shared decision-making. Yet, few studies have explored empirically, from patients’ perspectives, the extent to which the process of consent to treatment enables or disables patients’ participation in medical decision-making. Our paper examines patients’ attitudes towards the consent process, exploring how and why these attitudes influence patients’ active participation in decision-making and considering possible consequent medico-legal issues. Data were collected longitudinally using semi-structured interviews and field observations involving 35 patients and 19 of their caregivers, in an English hospital between February and November 2014. These indicate that generally patients defer to the doctor in respect of treatment decision-making. Although most patients and their caregivers wanted detailed information and discussion, they did not necessarily expect that this would be provided. Further, patients perceived that signing the consent form was an obligatory routine principally to protect doctors from legal action should something go wrong. Our study suggests that patients’ predominantly paternalistic perceptions of the consent process can not only undermine attempts by doctors to involve them in decision-making but, as patients are now considered in law as informed actors, their perceptions of the consent form as not being in their interests could be a self-fulfilling prophecy if signing is undertaken without due consideration to the content.

Publication Type: Article
Additional Information: Copyright Sage 2015
Publisher Keywords: Patients, caregivers, consent, UK NHS
Subjects: R Medicine > RA Public aspects of medicine
R Medicine > RC Internal medicine
Departments: School of Health & Psychological Sciences
SWORD Depositor:
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