Alderson, Dorothea Priscilla. 1988. Informed Consent: Problems of Parental Consent to Paediatric Cardiac Surgery. Doctoral thesis, Goldsmiths, University of London [Thesis]

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Abstract or Description

This thesis reviews the development over the last 40 years of medical, legal, ethical and psychological concepts of informed consent and then evaluates the abstract theories in relation to the practice of achieving consent to paediatric cardiac surgery. For two years I observed the work of two paediatric cardiology units in the clinics, wards and staff meetings, and interviewed families and staff. Paediatric cardiac surgery is not a typical kind of surgery, involving as it does proxy agreement to very high risk operations. Yet these characteristics help to illuminate the whole process of achieving informed consent since, because of them, decision making tends to be drawn out. Extended discussion reveals the dependent position of patients, the limits to medical knowledge and skill in a developing specialty, and the kinds of information concerning surgery which are exchanged between families and hospital staff. The experience of consent has two main elements: to be rationally informed and to feel in voluntary agreement. In order to explore the duality of this thinking, feeling experience which involves doubt and trust, it is necessary to develop a sociological means of taking into account feeling and relationships. Concepts of informed consent which concentrate on reason and exclude feeling are inadequate. These inadequacies are seen more clearly when sociology attempts to overcome the split between reason and emotion and to see how they relate. The different perspectives, knowledge and values of doctors and of families and how these affect the consent process then become apparent. Influences on the consent process are shown at three levels: the way medical care is organised; the form and content of the information exchanged; and the relationships between the children, parents and staff. Clarifying some of the problems encountered by families and doctors may help them to approach more nearly to the impossible yet important ideal of informed and voluntary consent.

Item Type:	Thesis (Doctoral)
Identification Number (DOI):	https://doi.org/10.25602/GOLD.00033735
Keywords:	informed consent, paediatric cardiac surgery, medical care
Departments, Centres and Research Units:	Sociology
Date:	1988
Item ID:	33735
Date Deposited:	05 Jul 2023 15:34
Last Modified:	05 Jul 2023 18:00
URI:	https://research.gold.ac.uk/id/eprint/33735

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