Nuances of Informed Consent: The Paradigm of Regional Anesthesia

Informed Consent is the primary method employed in clinical practice by which patients and their physicians incorporate a patient_s values, preferences, expectations, and fears in treatment decision-making (1). Grounded in the philosophical concept of autonomy, it reflects a departure from the paternalistic tradition of western medicine, revealed first in the writings of Hippocrates and remaining dominant until recent times (2). The practice of Informed Consent in the clinical arena evolved primarily through the medical profession_s responses to various decisions by the courts. In this paper we review the concept of Informed Consent from a historical and ethical perspective and, in so doing, provide a context for a discussion of these considerations to a specific clinical domain, that of regional anesthesia.