THE CONCEPT OF SELF-DETERMINATION AND THE PROBLEM OF SENSE-MAKING IN INFORMED CONSENT

Белялетдинов Р.Р.

Abstract

. Until the mid-1950 s, only the doctor fully understood what is good, and assigned the patient the role of an extra-contractor with medical truth. A decade later, in bioethics, in connection with the emergence of informed consent, almost like in the Middle Ages, a dualism of two truths is born – medical and patient. The transition from self-determination to the concept of informed consent occurred through understanding the correlation of the good that the doctor represented, and the patient's right to know and articulate this knowledge in accordance with his ideas. Sense-making, and not only for the patient, but for anyone who is faced with biomedical trajectories in their own lives, carried out in the format of informed consent, becomes no less significant than the objective good of health or the prosperity of society. Meanwhile, most acts of informed consent de facto are still facts of self-determination, since they are of a formal nature. In addition, quite often the scientific community considers the sense-making of informed consent as a fictitious bureaucratic practice. Nevertheless, the philosophical criticism of a single concept of the good is also a criticism of the idea of uninformed self-determination, and this article presents some arguments about the impossibility of a complete translation of knowledge, the variability of value realism, and the limitations of philosophical conceptual universalism. The study analyzes cases that reveal the problem of informed consent and considers the problem of an objective understanding of the good in modern philosophy based on the ideas of J. Habermas, Ch. Taylor, A. Buchanan. The article substantiates the thesis that the value of informed consent, as opposed to the idea of self-determination, is reinforced in modern philosophy by the exhaustion of the concept of the universal good.

Keywords

: informed consent; self-determination; value realism; autonomy; good.

DOI: 10.31249/scis/2023.03.02

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