Informed Voluntary Consent in Action and Over Time: Rituals of Production and Routing of Forms, Data, and Signatures in Maternity Hospitals

Abstract

My research fills gaps in medical anthropology and the anthropology of bureaucracy regarding practices of patient agency, medical discretion, and the production and routing of informed consent within the contemporary medical setting. Developing an ethnography of documents from a Latour-Hull perspective, I examine informed consent forms as a network of non-human actors. My work focuses on signatures, forms, and the functions of informed consent, whether oral or written (paper or electronic), in public and commercial maternity care. Due to their mundanity, the paper/electronic and chronological dimensions of bureaucracy and the actual modes of development and routing of documents remain, as a rule, invisible and unproblematic. Meanwhile, the “biographies”/“careers” of medical documents used in maternity hospitals, and, in particular, the life cycle of the informed consent in obstetrics, can vary significantly depending on the medical facility and the woman in labor’s familiarity with the scripts of bureaucratic “ping-pong”; some Russian women manage to deconstruct hierarchical and informational asymmetries to their advantage using paper forms, signatures, and verbal negotiations, while others do not.