What exactly is informed consent?

What Exactly Is Informed Consent?

If you’ve ever had surgery or a medical procedure, you might remember signing a form listing a bunch of scary side effects. That form was part of something called informed consent. Doctors talk about it all the time, and during my training I had to write the phrase in almost every note—yet most people never learn what it actually means.

Let’s break it down in a way that makes sense.

So what is informed consent?

In simple terms, informed consent means you understand what you’re agreeing to before saying yes to a medical treatment.
It isn’t just a signature. It’s a conversation where you learn:

• What the treatment is
  (what the medication or procedure actually does)
  

• Why it’s being recommended
  (what problem it’s supposed to help)
  

• The benefits
  (how it might help you feel better)
  

• The risks
  (what side effects or complications could happen)
  

• The alternatives
  (other options you could choose instead, including doing nothing)
  

• The risks and benefits of those alternatives
  (because every option — even “wait and see” — has trade-offs)
  

• Your understanding of it all
  (your doctor should make sure you actually understand, not just assume)
  

These points come from the Joint Commission’s standards, which outline what has to be documented in your medical record whenever informed consent happens.

In other words, you can’t give real consent unless you actually know what you’re agreeing to — and feel free to say yes or no.

A quick history lesson

For a long time, medicine was very paternalistic. Doctors made decisions for patients and didn’t feel the need to explain anything. Patients were expected to trust the doctor completely.

That started to change in the early 1900s after a famous court case stated that every person has the right to decide what happens to their own body.

Later, the world learned about horrific unethical experiments — like the Tuskegee Syphilis Study and medical experiments during World War II. These events pushed medicine to create clear rules: no treatment or research should happen without the patient’s full, informed agreement.

Today, informed consent is supposed to be about honest conversation, not just a signature on a form.

The problem: what should happen… often doesn’t

Even though the idea of informed consent is written everywhere in medical training, it doesn’t always happen in real life.

At UnScripted, we’ve seen how a lack of true informed consent leads many people into treatment choices they later regret. Here’s why it keeps happening:

1. Time pressure

Most doctors are forced to rush because the system pays them based on how many patients they see—not the quality of the conversation.
It is literally impossible to fully explain risks, benefits, and alternatives in a 10–15 minute visit.

2. The power imbalance in psychiatry

Psychiatry is one of the few fields where a doctor can label a patient “not competent,” which can lead to forced hospitalization or forced medication.
Even when that isn’t happening, the mindset behind that power affects everything.

Doctors may feel they “know best” and worry that fully explaining side effects might “scare patients away” from a treatment. So they leave out major details.

3. Lack of real training

During my own training, informed consent was treated like paperwork — something you check off, not something you slow down for.
Residents and young doctors are overwhelmed with huge caseloads, and when you’re rushing from patient to patient, it’s easy to lose sight of how big each decision actually is.

Think about your own experience

Try to remember the last time you agreed to a medication or procedure:

• Did the doctor explain the chances of actual improvement?
  

• Did they go over the side effects, or just hand you the prescription?
  

• Did you feel rushed to sign something?
  

• Did anyone tell you about withdrawal risks or long-term effects?
  

• Did you have time to think—or were you expected to say yes on the spot?

For most people, the honest answer is: no, I didn’t get real informed consent.

What UnScripted wants you to know

You deserve a true informed consent process.
This often means you’ll need:

• A follow-up appointment
  

• Time to learn the risks, benefits, and alternatives
  

• Space to think before making a decision

You are not “difficult” for asking questions.
You are not “overreacting” for wanting to know what a medication might do to your brain, body, or life.

Informed consent is your right, not a favor someone is doing for you.

Why this matters so much in psychiatry

So many patients tell us the same thing:
“I never would have started this medication if someone had told me the full truth.”

They weren’t warned about withdrawal.
They weren’t told how long the medication might last.
They had no idea the side effects could change their relationships, personality, or daily life.

As a psychiatrist, I could only provide real informed consent by working outside the insurance system so I had the time it required. Most patients don’t have access to that.

And that’s exactly why UnScripted exists — to fill the gap the system leaves behind.

We’re here to help you understand what you’re agreeing to before you become a long-term patient. Because you deserve honesty, clarity, and time — always.

Dr. Marissa Witt-Doerring is a board-certified psychiatrist and co-founder of TaperClinic, specializing in psychiatric withdrawal and safe, individualized tapering.

Shah P, Thornton I, Kopitnik NL, et al. Informed Consent. [Updated 2024 Nov 24]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK430827/