In “The Concept of Informed Consent”, by Ruth Faden and Tom Beauchamp, they discuss the two primary philosophies of informed consent, which they label Sense1 and Sense2. Sense1’s primary focus is on patient autonomy and the requirements for true authorization. Under this definition, informed consent is given if “A patient with (1) substantial understanding and (2) substantial absence of control by others (3) intentionally (4) authorizes a profession to do intervention”. Overall, Sense1 concentrates on autonomous authorization and patients’ rights.
Conversely, Sense2 focuses on the legal aspects of informed consent. Sense2 is a policy-oriented lens that doesn’t take into consideration the patient’s right to autonomy. While Sense1 had specific steps to determine if autonomous authorization has given informed consent, under Sense2, any consent is informed consent. Autonomous authorization does not exist, merely authorization that has been well documented through procedures that satisfy the rules in institutional practice.
While Sense1 and Sense2 may seem mutually exclusive, they can be implemented simultaneously. For example, a patient may give autonomous authorization while also documenting said authorization in the form of a consent agreement, thereby reflecting both definitions of informed consent. However, just because both definitions of informed consent can be reached, it doesn’t mean they always are in practice. Faden and Beauchamp present and example wherein a minor gives the autonomous authorization to donate one of her kidneys to her dying twin sister. While the sister’s life is saved, because she is a minor, her parents decide to sue the healthcare team because they violated her Sense2 informed consent. This highlights that Sense1 and Sense2 are not only individually important but ought to be obtained when the situation grants it.
Ultimately, Faden and Beauchamp conclude that only Sense1 truly captures the traditional meaning of “Informed consent”, which I agree with. I would argue that, for most people, informed consent is given when a doctor explains the procedure to you and you decided to proceed. This is encapsulated in the Sense1 definition of informed consent and isn’t covered in the Sense2 definition. To me, Sense2 is more of a legal definition, and while important, doesn’t necessarily apply when strictly discussing bioethics and patients’ right to autonomy. Consequently, if I had to rank the value or importance of these definitions, I would say Sense1 should be prioritized over Sense2. ( Though, as illustrated by the kidney example, both ought to be obtained).