Reibl v. Hughes: the consent issue.

Inviolability of the person is the basic principle underpinning the concept of consent to treatment. Although it is not a new concept, consent has become a major medico-legal issue because of a shift, within the doctor/patient relationship, towards more autonomy for the patient and less paternalism from the doctor. This change has been given further impetus by legal decisions such as Reibl v. Hughes and Hopp v. Lepp. In this paper the author reviews the nature of the changes and the impact of the legal decisions on the doctor/patient relationship. He concludes that a legal approach to consent is sterile if it is a substitute to open communication between the doctor and the patient, or to their acceptance of a principle of "equality of two participants". Consent is based on the basic principal of the inviolability of the person, that is, the right, at all times, of every individual not to have his body tampered with without his permission or agreement, and to be the whole decision-maker on matters that affect his physical integrity. This right is not absolute: it may be abrogated by the state for health or judicial reasons, or the person may not be in a position to exercise it, such as when unconscious or because of mental disability. This paper will review present Canadian laws on consent. It will contrast the legal approach to consent to the ethical-humanistic approach which could be developed within the context of the doctor/patient relationship.