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August 8, 2026Journal of Medical Ethics

Grammar of ‘understanding’ in informed consent: a Wittgensteinian diagnosis

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Authors

HBHenry BairWills Eye Hospital

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Implication

Philosophical analysis reveals flaws in standard informed consent practices, suggesting better evaluation methods.

Key Points

  • This article examines the concept of 'understanding' in informed consent and critiques the reception model of understanding.
  • Analyzes Wittgenstein's philosophical insights on understanding from Philosophical Investigations.
  • Critiques the current institutional model focusing on information transfer and private mental states.
  • Suggests redesigning consent processes to emphasize demonstrated capacity over self-reported understanding.
  • Readability-focused consent interventions show inconsistent improvements in comprehension.
  • Demonstration-based methods like teach-back lead to more reliable understanding outcomes.
  • Four implications for consent design are proposed: evaluating comprehension, using teach-back, revising consent forms, and linking consent with capacity assessment.

Cite This Study

Henry Bair (2026) studied this question.

synapsesocial.com/papers/6a76db2df12abadc79816499https://doi.org/10.1136/jme-2026-112077
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Also Consider

Synapse has enriched 4 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Assessing Patients' Capacities to Consent to Treatment1988 · 1,412 citations
  2. 2The effectiveness of the teach-back method on adherence and self-management in health education for people with chronic disease: a systematic review2016 · 503 citations
  3. 3Closing the Loop2003 · 1,176 citations
  4. 4Informed consent document improvement does not increase patients' comprehension in biomedical research2009 · 47 citations