About the project

In medicine, respect for patient autonomy is a central concern.1 Respect for patient autonomy is maintained by obtaining informed consent before any intervention. Patients must be able to understand, process as well as evaluate the information given by physicians about the disease and its proposed treatment. This ability - capacity to consent - can be impaired or even completely absent due to certain circumstances, like a disease. If there are any doubts about the ability to consent, physicians have the duty to investigate the case in question and should check the ability to consent thoroughly - in doing so, they usually rely on their clinical assessment competence.2

However, there are also various standardised assessment instruments that are based on the cognitive and verbal abilities of patients. Comparative studies show that assessments with the help of and without these assessment tools sometimes did not produce the same results2 and that different physicians could not always achieve consistent assessments with the same tools.3 In addition, various studies point out that the emotional abilities and individual values of patients have so far been neglected in the design of the available tools.4,5,6  

We raise the question ifartificial intelligence (AI) can be used to support the assessment of capacityto consent, if it is able to tackle the weaknesses of the clinical assessmentand of applicable but not yet digital tools as well as even take on a role as asubstitute for conventional ways of assessing capacity to consent.

Against the backdrop of arapid development in the performance of artificial intelligence, an AI for determining the capacity to consent is by no means science fiction any more - it is coming close to being feasible. Therefore, within the framework of our research project, we want to take an early and critical look at the possible ethical, legal, technical and social implications of such a concept.   
In some way or another we all eventually become patients. Before any medical treatment takes place, we are asked to give consent. Effective and informed consent requires that we are capable of giving consent. If there are any rational doubts about our capacity to consent, the physician checks whether we are actually capable of consenting.

  1. Beauchamp, T.L. & Childress, J.F. (2009). Principles of biomedical ethics (6.ed.).Oxford University Press.
  2. Moye, J., Gurrera, R.J., Karel, M.J., Edelstein, B.& O’Connell, C. (2006).Empirical advances in the assessment of the capacity to consent to medical treatments: Clinical implications and research needs. Clinical Psychology Review 26, 1054–1077.
  3. Okai,D., Owen, G., McGuire, H., Singh, S., Churchill, R. & Hotopf , M. (2007). Mental capacity in psychiatric patients. Systematic review. British Journal of Psychiatry 191, 291–297.
  4. Breden, T.M. & Vollmann, J. (2004).The cognitive based approach of capacity assessment in psychiatry: A philosophical critique of the MacCAT-T. Health Care Analysis 12(4), 273–283.
  5. Charland, L.C. (1998). Appreciation and emotion: Theoretical reflections on the MacArthur Treatment Competence Study. Kennedy Institute of Ethics Journal 8(4), 359–376.
  6. Appelbaum, P.S. (1998). Ought we to require emotional capacity as part of decisional competence? Kennedy Institute of Ethics Journal 8(4), 377–387.