In recent years, in discussing informed consent obtained between a doctor and a patient, we normally endorse the so-called“ conversation model” over the“ information disclosure model” ― for good reason. The advantages of the“ conversation model,” which integrates two-way communication between a doctor and a patient, are that it pays much more respect to a patient’s autonomy and that the doctor can correct the patient’s misunderstanding during the process; they mark a distinction from the“ information disclosure model” which is based on simple one-way communication. Close examinations of the“ conversation model” reveal a hidden, essentially asymmetric relationship between a doctor and a patient, however. Furthermore, we can see that the model’s assumption that a patient is a“ reasonable person” who is always capable of making rational or reasonable judgments is not convincing at all, when we discuss patients who are rarely in a position in which they can give any reasonable thinking. It turns out that the model has several practical problems as well. Given the essential doctor-patient asymmetric relation, what do we need to apply the model in a more practical fashion? This paper attempts to give an answer to that question by examining Howard Brody’s“ transparency standard.” The standard makes the model meet practical and legal purposes required for actual medical practices, but appear to lead us to what I call“ moderate or liberal paternalism.”
