Fully informed consent can be needlessly cruel.

. . . After many years of experience as committed trialists and in the statistical and clinical value of the randomised clinical, we feel that uniform recommendation for full written informed consent, outlined for example by the Royal College of Physicians, may be not only for clinical trials but, far more important, unnecessarily cruel to. . . . We suggest that the process of informed consent should be viewed another straightforward instance in which the clinical judgment of the is paramount. Clearly, for a patient who wishes to know what underlies aspects of decision making, there is no doubt that a full explanation be given, together with all the necessary information about the trial. the other extreme a distraught patient, possibly within days of diagnosis a potentially lethal illness, may be unable to take in any but the most details. . . . The counter argument will be that we are advocating a "doctor knows best" approach. We are not. We wish to see this with the patient informed by the same wisdom, judgment, and which should be part of all aspects of clinical care. We believe that ethical pressure that has put us so much on the defensive is. . . .