Paying for informed consent

The Japanese Ministry of Health and Welfare has implemented a policy of pay ing physicians to explain the nature of the patient's medical condition and rite treatment plan. We describe the precepts of this policy and examine e thical dimensions of this development. We question whether this policy will be sufficient to ensure patients will have the opportunity to become infor med participants in medical decision making. The policy, also raises a broa der philosophical question as to whether informed consent is a fundamental ethical requirement of all doctor-patient encounters or an option that can be exercised by physicians for financial gain. The impact of this policy in Japan merits continued observation from abroad.