Is a phenomenologically informed consent possible?

Pat McConville (Deakin University )

Is a phenomenologically-Informed Consent possible?

For more than 30 years, Australia has required doctors to inform patients about medical interventions they are offered. The information doctors are required to disclose includes all risks which are “material”: that is, all risks to which a reasonable person in the patient’s position would be likely to attach significance. This is generally, and not unreasonably, interpreted to require the disclosure of medical risks: that is, the plausible physiological or health-related risks which might result from medical interventions. However, medical interventions can change patients’ lives and how they experience themselves and the world in ways which are not obviously medical, or even health-related. Should patients be informed about these non-medical, experiential, or phenomenological changes? Is it even possible to do so?

In this presentation I offer a personal example of an undisclosed, “non-medical” change – the audible ticking of an artificial heart valve replacement – as motivation for these questions. I consider the function of informed consent and the possibility that phenomenological changes might be material to patients. I consider and respond to three initial concerns with broadening out the meaning of information in this way. First, that patients experience things in an extraordinary variety of ways. Second, that it is difficult to communicate experiential or phenomenological changes. Third, that it is not clear that clinicians can or should be responsible for disclosing non-medical risks. Finally, I present a framework for describing phenomenological changes (developed in relation to artificial heart interventions such as Ventricular Assist Devices).