In “The Concept of Informed Consent”, Ruth and Tom discuss the idea of an informed consent. They claim that an informed consent may be thought of in terms of sense one, in which the person making the consent authorizes the action being done to him in an autonomous matter. For example, patient being fully aware of a kidney transplant procedure, willing to receive a kidney, and knowing the risks associated with the procedure is giving an informed consent in sense one. Sense two, on the other hand, an informed consent in sense to may refer to the legislative procedures that is required in order to carry out a medical procedure, and one of that does not necessarily contain an autonomously made consent of the individual herself.
Then, Katz argues that informed consent made in sense two should be closer to informed consent made in sense one, entailing that any legislation or procedural consent before an operation should mean that the patient should give an autonomous consent, notably by himself.
In one of his arguments, Kats argue that “shared decision” making between a patient and a doctor is not a decision made independently by the patient, and thus is not autonomous. However, when this example is given, it is not clearly stated whether what level of communication is intervening with the autonomous decision of the patient. Surely, doctors should not give physical threats to go through medical procedures. However, merely informing the patients about the procedure could not be considered as ‘forcing’ the patient to make the decision, and some clear distinction of how decision is forcefully imposed on the patient is needed.
In all circumstances, I believe that any steps taken to ensure that a fully authorized decision, for instance leaving one day in between making the decision, is rightfully justified in the grounds of making sure that the patient is fully aware of the situation. However, in examples such as minors needing to make informed decisions with the consent of a parent, matters become more complex. In this specific example, the criteria that I believe should be applied is whether we believe that the minor is able to make fully autonomous decisions with rational capabilities that resemble a full-grown adult.
This criteria should apply to every other cases of decision being made in favor of other people, and instead of setting rules such as restricting age or diagnosing patients as mentally ill and therefore granting others to make decisions for them, I believe that it is morally rightful that hospitals and governments make case by case evaluations of the rationality and autonomous capabilities of people.