Methylphenidate for Attention-Deficit/Hyperactivity Disorder.

know about the risks of the procedure. Do the benefits outweigh the risks? Jurors in states with the reasonablepatient standard can ask themselves, “Would I have wanted to know about this risk?” “Would it have affected my decision making?” Drs Drolet and Brower also express concerns about operationalizing the reasonable-patient standard. They argue that each patient’s informational needs are unique and that barriers to understanding this heterogeneity undermine the real-world experience of implementing a common standard. In the courts, the fixed normative reference point for a reasonable patient is what the jury (or, in the United Kingdom, the judge, because medical malpractice cases do not go before a jury) decides after hearing expert medical testimony and after deliberation about what a reasonable patient would deem material to the decision-making process. In clinical practice, there is undoubtedly variation in patients’ informational needs. Nonetheless, it is possible to identify the material information that reasonable patients value in making an intelligent decision, as evidenced by decision aids developed with input from patients and health professionals to support shared decision making.2 The development of decision aids has shown that complex and even anxiety-producing information can be effectively communicated to patients, a factor cited in the Montgomery case for why the risk of shoulder dystocia was not shared with the patient. Thus, decision aids can help address barriers to patient-physician communication and reduce variation in what physicians deem reasonable to communicate to patients. In the physician-based standard for informed consent, there are no fixed normative reference points. Still, physicians need training.3 Additionally, there is a need for high-quality informed consent tools like patient decision aids to be integrated into the clinical workflow. In linking informed consent to shared decision making, reasonable-patient standards can be defined and implemented, ensuring that patients receive care alignedwith their preferences, values, and goals.