In the more than 40 years since its introduction into case law in the United States in 1957,<sup>17 Salgo v. Leland Stanford Jr. University Board of Trustees, 317 P.2d 170.

Cliccare qui per andare alla sezione Riferimenti</sup> the concept of informed consent has become a central topic in the emerging disciplines of health law and bioethics, with a variety of works by leading scholars devoted to its evolution and interpretation.<sup>1 Appelbaum P.S., Lidz C.W., Meisel A.   Informed Consent: Legal Theory and Clinical Practice New York: Oxford University Press (1987). 

Cliccare qui per andare alla sezione Riferimenti, 4 Brock D.W. Informed consent Health Care Ethics: An Introduction Philadelphia: Temple University Press (1987).  98-126

Cliccare qui per andare alla sezione Riferimenti, 6 Faden R.R., Beauchamp T.L., King N.M.P.   A History and Theory of Informed Consent New York: Oxford University Press (1986). 

Cliccare qui per andare alla sezione Riferimenti, 11 Katz J.   The Silent World of Doctor and Patient New York: Free Press (1984). 

Cliccare qui per andare alla sezione Riferimenti, 13 Ludlam J.E.   Informed Consent Chicago: American Hospital Association (1978). 

Cliccare qui per andare alla sezione Riferimenti, 14 Meisel A., Kuczewski M. Legal and ethical myths about informed consent Arch Intern Med 1996 ;  156 : 2521-2526

Cliccare qui per andare alla sezione Riferimenti, 15 President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research Making Health Care Decisions 1   Washington, DC: Report US Government Printing Office (1982). 

Cliccare qui per andare alla sezione Riferimenti, 16 Rozovsky F.A.   Consent to Treatment: A Practical Guide Boston: Little, Brown (1984). 

Cliccare qui per andare alla sezione Riferimenti</sup> Informed consent to medical treatment and its counterpart, the refusal of treatment, have been recognized as important legal and moral rights. Communicating appropriate information to patients about treatment alternatives, thereby enabling them to make an informed choice, has likewise become an essential feature of professional–patient interaction.

Despite its importance, the duty to obtain the patient's informed consent to treatment is not absolute—several exceptions are generally recognized and accepted.<sup>1 Appelbaum P.S., Lidz C.W., Meisel A.   Informed Consent: Legal Theory and Clinical Practice New York: Oxford University Press (1987). 

Cliccare qui per andare alla sezione Riferimenti, 4 Brock D.W. Informed consent Health Care Ethics: An Introduction Philadelphia: Temple University Press (1987).  98-126

Cliccare qui per andare alla sezione Riferimenti, 6 Faden R.R., Beauchamp T.L., King N.M.P.   A History and Theory of Informed Consent New York: Oxford University Press (1986). 

Cliccare qui per andare alla sezione Riferimenti, 13 Ludlam J.E.   Informed Consent Chicago: American Hospital Association (1978). 

Cliccare qui per andare alla sezione Riferimenti, 15 President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research Making Health Care Decisions 1   Washington, DC: Report US Government Printing Office (1982). 

Cliccare qui per andare alla sezione Riferimenti, 16 Rozovsky F.A.   Consent to Treatment: A Practical Guide Boston: Little, Brown (1984). 

Cliccare qui per andare alla sezione Riferimenti</sup> One prominent exception refers directly to emergency care. According to this emergency exception, if immediate treatment is required to prevent death or other serious harm to a patient, that treatment may be provided without informed consent. Aware of this exception, some emergency physicians might be tempted to conclude that informed consent need not play a significant role in their professional activities. Such a conclusion, however, would be seriously mistaken, as this article attempts to show. In a recent multicenter study of more than 6000 ambulatory visits to US emergency departments (EDs), fully 49% of the visits were assessed as nonurgent;<sup>19 Young G.P., Wagner M.B., Kellerman A.L. , e al. Ambulatory visits to hospital emergency departments JAMA 1996 ;  276 : 460-465  [cross-ref]

Cliccare qui per andare alla sezione Riferimenti</sup> the emergency exception, therefore, would not apply in these situations. Because emergency physicians are less likely to have an ongoing relationship with their patients than many other physicians, the formal process of providing information about treatment alternatives and obtaining explicit consent to treatment can be more important in the ED than in other practice settings.<sup>12 Ladd R.E. Patients without choices: The ethics of decision making in emergency medicine J Emerg Med 1985 ;  3 : 149-156  [cross-ref]

Cliccare qui per andare alla sezione Riferimenti</sup> Because ED patients often have not had any control over the locus or the provider of their treatment, obtaining their informed consent may be the only readily available way to respect their autonomy as moral agents.

This article offers a review of the doctrine of informed consent, with particular attention to its role in the ED. The article discusses the foundations, essential features, and exceptions to the informed consent requirement. Informed consent is an important concept in both therapy and clinical research in the ED. (This article's focus is on informed consent to therapy; elsewhere this issue, ethical issues in emergency medicine research are addressed.)