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Contextual Informed Consent
Experiences of treatment failure can temporarily render patients willing to accept ever-increasing risks and costs. Not only does the doctrine of informed consent not acknowledge the potential impact of experience-sensitive preferences on patients’ decisions, but it relies on patients to bring suit to vindicate their rights to disclosure. This paper proposes an alternate intervention through a patient decision aid, the Patient Preference Tracker, that elicits patients’ original preferences over risk/cost and requires provider discussion to update this record. Clinics will bear the burden of showing compliance with this better disclosure technique through certification rather than relying on patient enforcement through costly litigation.