Informed Consent – How much is too much?

July 2017

Can too much information be harmful to your health? Informed consent is at the heart of many ongoing debates that seek to answer this question.

Informed consent refers to the permission granted in full knowledge of the possible consequences. Typically, it relates to that which is given by a patient to a doctor for treatment with knowledge of the possible risks and benefits. However, informed consent is a process that occurs both within healthcare and any research involving human studies.

There are many limitations and issues surrounding the process of informed consent that bring in to question its validity. One area that we at Spoonful of Sugar regularly consider within our work is the information that is given to patients around treatment side effects.

The informed consent process has the potential to increase patients experience of side effects purely by the mentioning of them as providing extensive information regarding adverse effects can generate nocebo responses; when the expectation of treatment side effects leads to those symptoms being realised. Extensive research has shown that including specific side effects within a consent form increases the incidence of the reporting of these symptoms. The variability in an individual’s risk perception in relation to side effects adds complexity to the issue.

Over the years researchers have investigated methods for minimising these nocebo responses whilst still maintaining patient autonomy, these are approaches SoS considers when designing patient support. One approach that has been suggested is contextualised consent which proposes a tailored approach to the information given, it considers adverse effects of a particular medication, the patient themselves and the illness concerned. Another method looks at how the information is presented, studies have shown that positive framing and personalising information helped patients to develop more functional treatment expectations and prevented expectation induced nocebo effects. These two techniques; framing and tailoring could go a long way to providing an effective informed consent procedure.

As of yet no consensus has been reached on the best way to approach the complex topic of informed consent and so continues the debate of ‘how much information really is too much?’