Informed consent is one of the fundamental principles of modern medicine, reflecting personal autonomy and the right to self-determination in relation to a proposed medical intervention. Although it is theoretically presented as a clear legal rule, according to which the patient receives relevant information and independently decides on their treatment, in practice, particularly in oncology, this concept takes on far more complex dimensions. It is precisely in this field of medicine that its sociological and ethical aspects come to the forefront, far exceeding the mere formality of signing a consent form.
From a theoretical standpoint, informed consent is grounded in the idea of autonomy, namely the right of every individual to make decisions about their own body and health. However, in real-life circumstances, especially when dealing with serious illnesses such as cancer, patients are confronted with fear, uncertainty, and significant emotional pressure. These factors can substantially affect their ability to fully understand the information provided and to independently evaluate the available treatment options. For this reason, the role of the physician becomes crucial.
The relationship between physician and patient cannot be reduced to a simple legal interaction in which one party provides information and the other makes a decision. Rather, it is a complex social relationship based on trust and communication, but also marked by an inevitable imbalance in knowledge and power. Traditionally, this relationship was characterized by paternalism, where the physician made decisions in the patient’s “best interest,” while the patient assumed a passive role. Although modern medicine has formally moved away from this model, its traces remain visible, particularly in oncology.
In systems that rely on medical protocols and multidisciplinary decision-making, treatment plans are often determined in advance based on professional guidelines. The patient is then presented with what is framed as the best, and sometimes the only, option. While such an approach is rooted in the principle of beneficence, it may limit the space for genuinely autonomous decision-making. This raises a critical question: does the patient truly choose, or merely confirm a decision that has already been made?
For a decision to be truly informed, it is not enough for the patient to formally receive information; it is essential that they understand it. Sociological research shows that the quality of communication between physician and patient plays a decisive role in this process. Information must be clear, accessible, and tailored to the patient’s level of education, emotional state, and life circumstances. Moreover, the time given to patients to make a decision is often crucial for their sense of control and security.
An additional challenge lies in the fact that oncology patients are often not in a state of full psychological stability. Fear of death, uncertainty of outcomes, and the complexity of treatment options may lead patients to defer decision-making to their physicians. In such circumstances, the formal fulfillment of informed consent requirements does not necessarily imply its substantive existence.
For this reason, contemporary medicine increasingly emphasizes the model of shared decision-making. Within this framework, physician and patient do not stand in a hierarchical relationship but act as partners. The physician contributes professional expertise, while the patient brings their own values, goals, and preferences. Only through such dialogue can a truly informed decision be achieved.
However, implementing this model in practice is far from straightforward. It requires time, advanced communication skills, and institutional support, as well as resources that are often lacking in healthcare systems burdened by organizational and economic pressures. When consultations are brief and superficial, informed consent is reduced to a formality rather than functioning as a meaningful process of understanding and choice.
An important aspect of this issue is the need for an individualized approach. Each patient is unique in terms of age, education, culture, and life circumstances. A universal model of information disclosure cannot adequately address these differences. Therefore, communication must be tailored to each individual patient in order to enable genuine understanding and decision-making.
Ultimately, informed consent in oncology cannot be viewed solely as a legal construct. It is a complex process encompassing legal, ethical, and sociological dimensions. Its essence lies not in a signed form, but in the quality of the relationship between physician and patient.
If we aim to speak of truly informed consent, we must move beyond formalism and shift our focus toward communication, trust, and respect for the patient as a person. Only then can this concept fulfill its fundamental purpose: the protection of patient dignity and autonomy in the most vulnerable moments of life.
More on this topic you can read in author’s paper:
Vukadinović, M. J. R., Radomirović, I. D., & Stjepanović, B. M. (2025). Sociological and ethical aspects of oncology patients’ informed consent within the legal framework of the Republic of Serbia. Sociološki pregled, 59(3), 865-888. https://doi.org/10.5937/socpreg59-58559
Cover photo: Image by freepik
Jelena Vukadinović Marković
Prof. Dr. Jelena Vukadinović Marković is Senior Research Fellow at the Institute of Comparative Law. Fileds of her interest include EU Law, Arbitration Law, International Business Law, Medicine Law.
The opinions and views published in the Blog section are exclusively the personal views of the author of the text and do not reflect the views of the Institute of Comparative Law.