Patients? perceived purpose of clinical informed consent: Mill?s individual autonomy model is preferred

Background Although informed consent is an integral part of clinical practice, its current doctrine remains mostly a matter of law and mainstream ethics rather than empirical research. There are scarce empirical data on patients? perceived purpose of informed consent, which may include administrative routine/courtesy gesture, simple honest permission, informed permission, patient-clinician shared decision-making, and enabling patient?s self decision-making. Different purposes require different processes. Methods We surveyed 488 adults who were planning to undergo or had recently undergone written informed consent-requiring procedures. Perceptions of informed consent purpose (from norm and current practice perspectives) were explored by asking respondents to rank (1?=?most reflective) 10 randomly-presented statements: ?meaningless routine?, ?courtesy gesture? ?litigation protection?, ?take away compensation rights?, ?inform patient?, ?make sure patient understand?, ?document patient?s decision?, ?discover patient?s preferences?, ?have shared decision?, and ?help patient decide?. Results Respondents? mean (SD) age was 38.3 (12.5); 50.4% were males, 56.8% had???college education, and 37.3% had undergone a procedure. From the norm perspective, the least reflective statement was ?meaningless routine? (ranked 1?3 by 2.6% of respondents) and the most reflective statements were ?help patient decide?, ?make sure patient understand?, and ?inform patient? (ranked 1?3 by 65%, 60%, and 48% of respondents with median [25%,75%] ranking scores of 2 [1,5], 3 [2,4], and 4 [2,5], respectively). Compared to their counterparts, males and pre-procedure respondents ranked ?help patient decide? better, whereas females and post-procedure respondents ranked ?inform patient? better (p?=?0.007 to p?