Mutation and Evolution of Informed Consent in the New Era
In the new era of 21 century, artificial intelligence and precision medicine change the clinical practice a lot. That patient-centered becomes the guideline of medical ethics. The informed consent doctrine is also been modified to be personalized and more precision. In Taiwan, there are five mutations derived from the doctrine. Relatives may sign the informed consent while patient is competent. Relatives may also sign to remove life support machines while patient is still treatable. Legal representatives can make decisions against the best interests of the patient. When a woman wants to terminate her pregnancy, she needs the consent of her husband. Rare complications should be informed to the patient or his/her relatives before invasive procedures or surgeries. Some of these mutations are evoluted progressively. Nonetheless, in the era of precision medicines, the content of informed consent should be personalized. Artificial intelligence or some calculators based on big data analyses can be used for risk assessment and alternative options selection. The equipment of the hospital is not the guarantee of quality. However, the successful rate of the operator should be taking into account in risk assessment.