The Ethics of Informed Consent in Sexual Medicine

Since the 1970s, the process of informed consent has been considered fundamental to effective healthcare practice. Rooted in the ethical principle of respect for patient autonomy, informed consent has been described as more than a mere ideal in healthcare. Unfortunately, little has been written about the importance of an adequate informed consent when prescribing interventions in sexual medicine. The focus of this paper will be to discuss the ethics of informed consent as applied to the practice of sexual medicine. Many of our interventions have sexual side-effects and it is unclear as to how well-prepared patients are to understand, navigate, and manage the oft undesirable side-effects of those medications that negatively impact sexual functioning. It is assumed that a complete and thorough informed consent process will improve patient adherence and satisfaction. This assumption will be examined, assessed, and critiqued throughout this essay.

It should be clear that the practice of informed consent is more complex than is often recognized. As ethicists have opined for decades, ethical principles are nuanced and overlapping. Although at first glance, the ethics of informed consent for medications with sexual side-effects would seem to be straightforward, in truth when discussing the human condition sexual medicine practitioners should understand that little is clear-cut and simple. The available literature, although limited, demonstrates unambiguously that a poorly conceived informed consent may result in more harm than good to our patients.

A truly valuable informed consent must be contextualized and tailored to the needs of each individual patient. Medicine, and all areas of healthcare, should strive for an informed consent process that respects the principle of patient autonomy and assists our patients in being active participants in their own healthcare decisions.