Why Informed Consent?
What is patient-centred care?
Patient-centred care is defined by patient inclusion in medical decision-making based on individual need, rather than being passive recipients of health professionals’ decisions. While arguments are made that in certain cases (e.g. acute appendicitis that requires surgery) patients need not be involved in medical decision-making, in the majority of medical cases that involve multiple options, collaborative decision-making adds value.1 Similarly, the Informed Consent Model (ICM) recommends that clinicians assist clients in making educated decisions by openly discussing all risks and benefits of medical interventions, possible side effects, alternative treatments, and decide collaboratively the best course of action.2
The WPATH-SOC as it stands may constrain clinicians’ abilities to practice according with basic pillars of medical ethics – namely respect for autonomy, and justice.3 In practice, informed consent respects a patient’s autonomy by viewing and treating patients as having the capacity to make individual medical decisions about their bodies.4 Justice, on the other hand, is also affirmed through informed consent, as ICM upholds the ethical duty to distribute health care resources equitably.5
In the context of gender-affirming medicine, WPATH-SOC and the Diagnostic and Statistical Manual of Mental Disorders (DSM) used to diagnose gender dysphoria limit trans people’s autonomy and justice in accessing hormones and surgeries – medical interventions that have been empirically evaluated and deemed safe and effective treatments.6 7 8 9