The Consent Continuum: A New Model of Consent, Assent, and Nondissent for Primary Care

Marc Tunzi, David J. Satin, Philip G. Day

Research output: Contribution to journalArticlepeer-review

7 Scopus citations


The practice around informed consent in clinical medicine is both inconsistent and inadequate. Indeed, in busy, contemporary health care settings, getting informed consent looks little like the formal process developed over the past sixty years and presented in medical textbooks, journal articles, and academic lectures. In this article, members of the Society of Teachers of Family Medicine (STFM) Collaborative on Ethics and Humanities review the conventional process of informed consent and its limitations, explore complementary and alternative approaches to doctor-patient interactions, and propose a new model of consent that integrates these approaches with each other and with clinical practice. The model assigns medical interventions to a consent continuum defined by the discrete categories of traditional informed consent, assent, and nondissent. Narrative descriptions and clinical exemplars are offered for each category. The authors invite colleagues from other disciplines and from the academic ethics community to provide feedback and commentary.

Original languageEnglish (US)
Pages (from-to)33-40
Number of pages8
JournalHastings Center Report
Issue number2
StatePublished - Mar 1 2021


  • assent
  • clinical ethics
  • doctor-patient communication
  • family medicine
  • informed consent
  • nondissent
  • primary care

ASJC Scopus subject areas

  • Health(social science)
  • Issues, ethics and legal aspects
  • Philosophy
  • Health Policy


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