The Ethics of Consent: Theory and Practice

Article excerpt

The Ethics of Consent: Theory and Practice Franklin G. Miller and Alan Wertheimer, Editors. Oxford: Oxford University Press, 2010. ISBN 978-0-19-533514-9; 416 PAGES, CLOTH, $39.99.

If you have never considered the pivotal position that consent occupies in our lives, Franklin Miller and Alan Wertheimer's book The Ethics of Consent will broaden your perspective. Through a series of provocative essays by variety of experts, this book systematically analyzes the concept of consent-a communicative act that possesses not only moral authority but also the power to morally transform relationships-through an assortment of contexts in which consent performs a moral or legal function. From sex to politics, consent significantly shapes our social lives and interactions by establishing boundaries, providing gates, and even serving to bind us to one another (4). While some of the early chapters are technically challenging, the pervasiveness of consent in Western culture and the diversity of topics covered will render The Ethics of Consent appealing to a broad range of audiences.

The book is divided into two main sections: the first addresses theoretical aspects of consent including its nature, history, and issues of autonomy, paternalism, hypothetical consent (surrogacy), and consent to harm. The second examines practical domains in which consent plays a pivotal role-domains of sex, politics, law, contracts, research, and medicine. The pre-suppositional paradigms for most of the essays in the book are the dual concepts of personal sovereignty and social contract theory whereby individual consent grounds social relations through its protective or facilitative functions. (44). In that light, the critical concept advanced throughout the book is shown to be that consent is a transformational act, effecting the moral transformation of relationships, making interpersonal actions permissible that would be impermissible without it, and granting to others rights not previously possessed. (169)

While the book addresses a number of stimulating questions, the chapter on medical informed consent was particularly intriguing, suggesting that the pendulum of the physician-patient relationship is still in motion. In this chapter, Stephen Joffe and Robert Truog demonstrate a distinctive approach to medical informed consent, exploring it within the unique context of the fiduciary physician-patient relationship. …