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consentObtaining consent from a patient prior to treatment or from a research subject is a relatively new concept.  In the late 18th century, Benjamin Rush told doctors to “yield to patients in matters of little consequence, but maintain an inflexible authority over them in matters that are essential to life”.  In subsequent years the concept of informed consent grew rapidly to take on the relatively well-developed form it now has.  Even so, obtaining genuine informed consent in practice often falls short of displaying respect for the decision-making capacity of the patient or research subject.  This is the primary idea behind the requirement for informed consent, that is, the basic ethical principle that persons are owed respect for making their own autonomous decisions.  For informed consent to be adequately served the person must be provided with all of the relevant information in the appropriate context.  Not only can consent be tricky in clinical practice, but when it comes to research there may be ethically justifiable circumstances in which consent may be waived.  Furthermore, consent can take on even more complex characteristics when it is expressed in an advanced form such as in a medical advance directive, or in organ donation after death.