Analysis of the Concept of Informed
Consent: The Theory
This chapter, in essence, is an exploration of the concept of informed consent. What are the values behind it? Is it possible? Is it desirable? The first section presents background material on an informed consent requirement: the values behind an informed consent requirement and whether psychoanalysis shares those values. The second section discusses what the standard elements of informed consent are in the psychoanalytic context. The third section considers whether informed consent to psychoanalysis is even possible. The fourth section discusses the likely (or possible) effects of an IC requirement, while keeping in mind alterations in certain technical precepts, such as anonymity, that an IC requirement entails. Is the IC largely therapeutic or largely countertherapeutic, and how so? The fifth section explores the process view of IC. The last section responds to the claim that an informed consent requirement will have little effect on patients generally, and so is unimportant to study.
We should declare at the outset that we approach this issue from the point of view of the largely classical analyst. Thus, we rely on concepts such as abstinence that other schools of psychoanalysis do not make use of. We recognize that the psychoanalytic community today is quite pluralistic and various members of the community may have different views on our topic.
In what follows, we briefly sketch out some likely differences in different schools of psychoanalysis in the IC context, recognizing that some of what we say will be caricature-like. For instance, Kleinians are freer and faster with interpretations than classical analysts, and tend to focus on deep, archaic fantasies more than pedestrian concerns involved in living in the world. So an informed consent may involve thinking about things in a more superficial way than a Kleinian would like. On the other