Medical ethics and informed consent in invasive medical procedures

The issue of what is required of physicians in communicating to patients th e risks involved in invasive medical procedures is discussed from rite pers pectives of the court, the ethicist, and the patient. Courts in the United States judge the adequacy of this communication on the basis of information disclosure, although they differ as to whether physicians must meet the pr ofessional standard or the reasonable-person standard. Ethicists emphasize a patient-centered standard, as well as the concept of substantial understa nding, A study designed to elicit the patient's perspective found that most patients prefer that decision-making be shared by physician and patient, t hat patients want risk information, and that the largest number of patients prefer that physicians use words rather than numbers to describe risk. How ever, the very wide range in patient understanding of such terms as probabl e or possible raises the question of whether using such terms achieves subs tantial patient understanding of risk, (C) 1999 by Excerpta Medico, Inc.