Informed consent: The politics of intent and practice in medical research ethics

Abstract

Informed consent is a key feature of risk management in medical research. This review outlines the history of the consent requirement and describes its diverse forms through a review of anthropological studies of consent practices. We make a distinction between the politics of intent and the politics of practice to show how the consent requirement has become entrenched in practices through insistence on particular morally sanctioned intentions regardless of whether these intentions are ever realized. We draw attention to the importance of socioeconomic contexts, material practices, and the ethicopolitical dynamics that undergird the resilience of informed consent. We conclude that informed consent has become so ubiquitous thanks to an ability to conjure a stable image of a recognizable and manageable procedure with a particular moral appeal, while simultaneously serving as an empty signifier: an image onto which people can project very different hopes, concerns, and expectations.