{"title":"认知变革的医疗程序和知情同意。","authors":"Rajeev R Dutta","doi":"10.1093/jmp/jhaf025","DOIUrl":null,"url":null,"abstract":"<p><p>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.</p>","PeriodicalId":47377,"journal":{"name":"Journal of Medicine and Philosophy","volume":" ","pages":""},"PeriodicalIF":1.9000,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Epistemically Transformative Medical Procedures and Informed Consent.\",\"authors\":\"Rajeev R Dutta\",\"doi\":\"10.1093/jmp/jhaf025\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>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.</p>\",\"PeriodicalId\":47377,\"journal\":{\"name\":\"Journal of Medicine and Philosophy\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":1.9000,\"publicationDate\":\"2025-09-24\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Medicine and Philosophy\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1093/jmp/jhaf025\",\"RegionNum\":3,\"RegionCategory\":\"哲学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"ETHICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Medicine and Philosophy","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1093/jmp/jhaf025","RegionNum":3,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ETHICS","Score":null,"Total":0}
Epistemically Transformative Medical Procedures and Informed Consent.
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.
期刊介绍:
This bimonthly publication explores the shared themes and concerns of philosophy and the medical sciences. Central issues in medical research and practice have important philosophical dimensions, for, in treating disease and promoting health, medicine involves presuppositions about human goals and values. Conversely, the concerns of philosophy often significantly relate to those of medicine, as philosophers seek to understand the nature of medical knowledge and the human condition in the modern world. In addition, recent developments in medical technology and treatment create moral problems that raise important philosophical questions. The Journal of Medicine and Philosophy aims to provide an ongoing forum for the discussion of such themes and issues.