Why is informed consent necessary?

I don’t like to get political on this blog, but this particular question has popped up a lot lately, and I’d like to address it from the point of view of a patient. Biomedical ethics has been mostly ignored in the wake of the pandemic, with medical science seeking to implement coercive methods of improving vaccination rates.

It seems that the goalposts are moving in modern times on the idea that informed consent is a central part of modern medicine. I recently read an article in the Journal of Biomedical Ethics in which the author argued that the idea that informed consent was necessary to create trust in the medical profession was problematic. Essentially, his argument was that if the goal of medicine is to ensure that a patient take medicine responsibly, that the trust of the physician could be replaced with other incentives, such as paying the patient to take the medicine.

This has in fact been done in some places. I’m not fond of the idea, but to me, it is clearly the lesser evil. Because the alternative is far more coercive, to the point that it negates the idea of consent. If we consider the argument above though, it sounds like a fancy way of saying the ends justify the means. I think there are plenty of example in human history of how this goes horribly wrong. At this point, some places are implementing coercive vaccine passport programs to create a lower class of citizen, the one who will not prove he is vaccinated.

To me, it is this proof part that is disturbing. Presumably we waive our right to privacy when we obtain our vaccine passports. But I really don’t like the idea of sharing my private medical information with others. Not because it’s super important that people don’t know my vaccination status, but because of the slippery slope that it brings. Today we outlaw COVID, what do we outlaw tomorrow? STDs? Should you have to prove that you are free of STDs to go to a nightclub? Genetically inherited diseases? Dementia? Schizophrenia?

As a patient I say this: informed consent acts as a check to the considerable power we grant to doctors to act in times we cannot act, in ways we cannot fathom. Just as we take great care to ensure that politicians do not become dictators, it is all too clear today that we must be equally concerned about the doctors.