Faden and Beauchamp make the claim in “The Concept of Informed Consent” that it is possible to have sense1 of informed consent (autonomous authorization) and fail to have sense2 of informed consent (policies that are enforced in the context of institutions). It is also possible they claim to have the roles reversed, where informed consent in sense2 has been achieved but not sense1. Their argument is valid, however in order to resolve many of the issues they bring up near the end of the selected passage, it is imperative to implement (or atleast strive to do so to the best of one’s ability) both sense1 and sense2 of informed consent at all times in medical practice, so as to protect the doctor/researcher and patients/subjects.
Sense1 of informed consent in medicine emphasizes that a patient must not simply yield to a professional when enrolling in research or commencing a medical program, but rather have the competence to understand disclosed information and freely agree to such a thing. While this does aim to ensure that autonomy is upheld and doctors are not able to implement paternalistic measures, problems are able to arise in practical situations. For example, when a doctor performs surgery on someone who may actually have autonomously authorized verbally said procedure, but when something accidentally goes wrong then sues the doctor for malpractice. In this instance, sense2 of informed consent is necessary to protect the doctor in the court of law.
Conversely, sense2 of informed consent in medicine is defined as authorization deemed to be effective for medical and research settings; it satisfies the rules of an institution and is heavily relied upon in legal situations. Sense2 aims to settle the problem presented when only sense1 is relied upon. However with simply sense2, patients may be unprotected from what they personally view as harm. The legal authorization of research or medical intervention by a patient effectively transfers responsibility and authority to the professional and if the criteria that constitutes the legal authorization (i.e. sense2) does not employ the need of a subject’s competence to understand disclosed information and freely agree to such a thing then other problems arise. Thus reinforcing the fact that sense1 is needed to protect patients.
The authors end the passage by affirming that sense2 should and often is developed with sense1 in mind, but bring up some problems about how to exercise both in practice. I argue that both should be applied at all times, even for minor procedures so that patients and doctors are protected both in terms of general wellness and legal situations.