J Med Ethics 31:93-96 doi:10.1136/jme.2002.002220
  • Clinical ethics

Informed consent in the Pakistani milieu: the physician’s perspective

  1. A M Jafarey,
  2. A Farooqui
  1. Department of Surgery, Aga Khan University, Karachi, Pakistan
  1. Correspondence to:
 Dr A M Jafarey
 Department of Surgery, Aga Khan University, PO Box 3500, Stadium Road, Karachi, 74800, Pakistan;;
  • Received 21 October 2002
  • Accepted 4 December 2003
  • Revised 3 November 2003


Informed consent enjoys an unassailable position in both clinical and research situations as a safeguard of patients’ rights. Keeping the patient involved in the decision making process is easier when there is direct communication with the individual. The Pakistani milieu offers challenges to this process because crucial decision making is often done by family members or is left entirely up to the attending physician. There seems to be a general acceptance of this shifting of focus from the individual to other players. This also raises certain ethical dilemmas for physicians who may feel uncomfortable with communication which excludes the patient or in accepting a paternalistic primary decision making role. The objective of this informal qualitative study was to ascertain physicians’ perceptions regarding the process of information delivery to the patient in the Pakistani context and the various influences acting upon it.