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Recent insights into decision-making and their implications for informed consent
  1. Irene M L Vos,
  2. Maartje H N Schermer,
  3. Ineke L L E Bolt
  1. Department of Medical Ethics and Philosophy of Medicine, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
  1. Correspondence to Dr Ineke L L E Bolt, Department of Medical Ethics and Philosophy of Medicine, Erasmus Medical Center, Rotterdam, The Netherlands; L.Bolt{at}


Research from behavioural sciences shows that people reach decisions in a much less rational and well-considered way than was often assumed. The doctrine of informed consent, which is an important ethical principle and legal requirement in medical practice, is being challenged by these insights into decision-making and real-world choice behaviour. This article discusses the implications of recent insights of research on decision-making behaviour for the informed consent doctrine. It concludes that there is a significant tension between the often non-rational choice behaviour and the traditional theory of informed consent. Responsible ways of dealing with or solving these problems are considered. To this end, patient decisions aids (PDAs) are discussed as suitable interventions to support autonomous decision-making. However, current PDAs demand certain improvements in order to protect and promote autonomous decision-making. Based on a conception of autonomy, we will argue which type of improvements are needed.

  • informed consent
  • decision-making
  • autonomy
  • psychology

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  • Contributors All three authors contributed to the conception, writing and editing of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.