Epistemically Transformative Medical Procedures and Informed Consent.

Abstract

I argue that true informed consent is impossible to obtain for certain medical procedures in which epistemic transformation occurs. Cases in which undergoing a procedure itself provides new experiential information, that is, phenomenal knowledge (what I call "knowledge-what-it's-like"), true informed consent for that procedure cannot be attained from knowing facts about the procedure ("knowledge-that") alone. If epistemically transformative medical procedures indeed undermine informed consent as I argue they do, I suggest that there are important implications for the decision-making of patients considering these procedures (e.g., chemotherapy, invasive surgeries, cochlear implants, gender-affirming procedures). Rather than solely communicating biological, clinical, and epidemiological facts about procedures, clinicians should supplement pre-procedure counseling with previous patient testimonials or even virtual/augmented reality to compensate (albeit partially) for the "knowledge-what-it's-like" that is absent prior to undergoing epistemically transformative medical procedures. Although these interventions may not (accurately) convey what it is like to undergo the procedure, they address the traditionally under-explored experiential aspect of medical treatments in medical decision-making from the patient's perspective.