Current informed consent practices conform to the informed consent paradigm. Our intention is finally to promote patient autonomy through the provision of information intended to remove the information differential between doctor and patient. ICP is fundamentally flawed, since it is impossible to comprehensively and explicitly inform. A fundamental problem is our reliance on the container-conduit metaphor of informing. As a linguistic act, this metaphor conceptualises the process of informing as passive, when in reality informing and consequent sense-making are parts of (...) an individualised, personal and active process. The difficulties of the ICP are discussed, as are possible alternative strategies. Alternative models are also discussed. Concluding suggestions include drawing on an ethics of responsibility, incorporating the notion of informed consent as a transaction, debating the issues raised here and promoting the ethical empowerment of practising doctors. (shrink)