In Consent: Bridging the Gap between Doctor and Patient, Mary Donnelly asks why our health-care system operates in a way that often excludes patients from decisions about their own health-care.
She explores the roots of medical paternalism in Ireland and elsewhere and presents the arguments for more patient-centred decision-making. She argues that patients must be given adequate information about their medical situations and that this information must be delivered in a way that patients can understand. It is not enough to have the patient sign a consent form which serves only to protect the doctor from legal action without adding anything to the patient's understanding. Because of its focus on consent forms rather than the realities of patient understanding, the legal system in Ireland has not operated to further patients' interests in any meaningful way. This lack of meaningful legal protection is even more problematic when patients are especially vulnerable perhaps because they are children or because they have a mental disability or mental illness. Donnelly argues that it the law as it stands cannot provide adequate protection for patients and that a legally enforceable Charter of Rights for Patients is essential if real patient-centred care is to be provided.