Being targeted by Nir Eyal's ingenious argument,1 I am pleased to have the opportunity to respond. It is fairly obvious that my utilitarian argument accomplishes what it is supposed to accomplish, namely a defence of the idea that the notion of informed consent should take roughly the form it takes in Western medicine. But does it fly in the face of commonsense moral thinking? I will argue that it does not.My argument is based on hedonistic utilitarianism.2 This means that it (...) is an instance of the general pattern of argumentation that Eyal presents. It takes slightly different forms in its defence of the place of informed content in research and in the clinic. For reasons of space I will focus exclusively on the clinic.The thrust of the argument is as follows. In many cases, we should allow people to refuse treatment for the simple reason that they presumably know best what is in their interest. As J S Mill used to argue, each person has a privileged position with respect to her own life, which, as it were, she experiences from the inside, and from which she cannot walk away. …. (shrink)

Increasingly, bioethicists defend informed consent as a safeguard for trust in caretakers and medical institutions. This paper discusses an ‘ideal type’ of that move. What I call the trust-promotion argument for informed consent states:1. Social trust, especially trust in caretakers and medical institutions, is necessary so that, for example, people seek medical advice, comply with it, and participate in medical research.2. Therefore, it is usually wrong to jeopardise that trust.3. Coercion, deception, manipulation and other violations of standard informed consent requirements (...) seriously jeopardise that trust.4. Thus, standard informed consent requirements are justified.This article describes the initial promise of this argument, then identifies challenges to it. As I show, the value of trust fails to account for some commonsense intuitions about informed consent. We should revise the argument, commonsense morality, or both. (shrink)