Consent: a practical guide.

Societal change through an increase in knowledge and accessibility of education as well as a push for autonomy has contributed to a shift in the balance of power from clinician to patient (especially in the last 20 years). This drive for personal autonomy has seen a shift from medical paternalism, a consequence of ignorance, to personal autonomy, a continuously evolving by-product of 17th century liberalism as expressed and facilitated by access of information. Consequently, patient-centred care has become the new standard for health care involving a two-way communication process of shared information and informed decision-making. At its centre is the patient's right to accept or decline treatment recommended by a clinician, be it detrimental or beneficial. Clinicians must recognize and appreciate this shift to patient-centred care and its legal ramifications.