IO9: The controversial doctor who pioneered the idea of “informed consent”


When I was in college, I took a project course which focused on the policy and regulatory implications of private space travel. One of the groups in the class looked at the idea of informed consent, because the fatality risk of space travel was at the time roughly 100 times that of travelling by car, on a population basis (accidents per vehicle miles travelled didn’t really work as a basis for comparison). Their conclusion was that the average person had no real idea what this level of danger meant, so giving informed consent would be difficult for a typical traveller.

This conclusion should be troubling in many fields other than (theoretical) commercial space travel. How many medical operations do we not fully understand the risks of? What actually needs to be done to change this? And are we acting rationally by deferring to medical providers? This fully reinforces my belief that, at the very least, we as people need to have a basic statistics education before being trusted to understand the implications of our decisions.

End-of-life care provides an important case study for the issues of informed consent. My grandfather had lung cancer towards the end of his life, and he made the rational decision that continuing chemotherapy to prolong his life would not be worth the decline in quality of life for what time he had left. It is my opinion that most people do not fully understand the implications of decisions like the one my grandfather made, and are pressured to opt for expensive treatments that leave them bedridden and in pain for the little extra time they do have. To add insult to injury, the one interesting policy attempt to fix this was sabotaged by ignorance and labeled “death panels”.

Medicine is the easy example here, as it’s a field we both must avail ourselves of regularly and do not fully understand. A real complication is that medicine (law as well) has set itself up to be more opaque than necessary, in order to benefit its practitioners. While Beecher’s research has helped create some protections in the medical establishment, there is ultimately no shield against ignorance.


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