Historical Foundations of an Informed Consent of a Patient and Contemporary Challenges in Practice


  • Mikheil Bichia
  • Ilona Gagua




Personal Autonomy of a Patient, Paternalism, Historical Excurse, Modern Approaches, Court Practice, Burden of Proof, Compensation.


The idea of protecting the patient's informed consent is not an offspring of the modern era. It was known in the antique period, but it had a different meaning - the concept of informed consent was based on the patient's social status. The long-standing paternalistic attitude disregarded the patient's will and gave the doctor absolute freedom to decide on the issues related to medical intervention for the patient. This approach was based on the belief that the doctor knows what would be better for the patient.

At the beginning of the twentieth century, priority was given to the principle of patient’s personal autonomy, which slowly deepened its roots in judicial practice. Modern reality pays attention to the patient's free will, thereby bringing to the forefront the idea of respect for human personal autonomy and dignity. For this purpose, the most important postulates of giving the patient's informed consent (voluntatiness, ability to understand, the patient's authority to make decisions, etc.) were formulated, which cumulatively require protection.

The issue of distribution of the burden of proof is noteworthy. Clinics must work hard to meet their burden of proof, as violations of informed consent are grounds for nonpecuniary damages. If it is accompanied by inhuman or degrading treatment, this is considered a qualifying factor in the European Court of Human Rights and increases the amount of compensation for non-pecuniary damage.

In the field of effective protection of rights, it is important to consider more the approaches of the European court practice of human rights. For this purpose, not only the formal aspect of informed consent should be in focus, but also the protection of its content.

Author Biographies

Mikheil Bichia

Doctor of Law, Visiting Lecturer at Ivane Javakhishvili Tbilisi State University, Affiliated Professor at European University, Expert in Accreditation of Higher Education Programs, Lawyer, Mediator.

Ilona Gagua

Doctor of Law, Visiting Lecturer at Ivane Javakhishvili Tbilisi State University, Professor at SEU National University of Georgia, Associate Professor at Davit Agmashenebeli University of Georgia, chief consultant of the Civil Affairs Chamber of the Supreme Court of Georgia - Assistant Judge.


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How to Cite

Bichia, M., & Gagua, I. (2024). Historical Foundations of an Informed Consent of a Patient and Contemporary Challenges in Practice. Journal of Law, (1). https://doi.org/10.60131/jlaw.1.2024.7938