Shifting Paradigms in Women’s Health Care: From Informed Consent to Informed Choice

This article discusses the paradigm shift in health care and bioethics from the concept of informed consent to informed choice. Informed consent is linked to the concept of respect for autonomy-one of the four pillars of bioethics. This concept requires health care givers to share information with patients so they can make appropriate health care decisions. However, the concept of informed consent has been critiqued as being paternalistic and not attentive to the complexities of modern health care decisions. As a result of a paradigm shift in health care and ethics, favoring autonomy over other principles-informed consent evolved to the more patient-centered concept of informed choice. Even so, feminist bioethicists critique the mainstream model of informed choice as being inattentive to inherent power dynamics within health care and society which may influence decision making. Drawing on the model of midwifery in Canada, this paper outlines an approach to health care that incorporates feminist definitions of informed choice. This paper reviews the necessary criteria for informed choice to be attentive to the individual needs of women. Using the model of midwifery in Canada as an example, this paper demonstrates how feminist approaches to informed choice should be preferred in modern health care settings.