As human beings, we all have the right to our own lives and the control over our own bodies. Thus, doing something serious to someone else's body requires consent. Acts that require consent include:
Plain ConsentThe simplest form of consent is plain consent. Someone saying "uh, yeah, sure" or whatever. But what if the person doesn't know what s/he's getting into? What if s/he's not in a position to say no? We don't think that children and mentally handicapped people can consent to everything. And with adults, we still have issues about them knowing what they are getting into and not getting exploited. See Consenting Adults and Informed Consent below. We also have the reverse issue, with consent being given such high priority that it actually takes away people's right to their own bodies. See Implied Consent below.
Consenting AdultsThe idea that everyone involved is not only consenting, but also an adult — and thus defined as a person capable of giving meaningful consent. Adults are allowed to do business, and also to have sex with each other.
Informed ConsentThe idea that everyone involved is not only consenting, but also understands what they are consenting to.
Problems with Consenting Adults and Informed ConsentWhile both constructs are useful, they are far from waterproof. What if someone is an adult but not informed? Scams are not cool! Or what if someone who's not adult is "informed" and consents to something that is Not Safe For Kids and later regrets it? One of the main points of having age limits is that kids should not be forced to take that kind of responsibility! It's not their own fault if they get into a situation that hurts them, not matter how good an idea it seemed at the time. And also, what if someone is technically adult and technically informed, but has a mental handicap that makes them unfit to make the decision?
Implied consentWe also have the issue of people not wanting to formally ask each other for consent all the time. For most people in a relationship, it would feel quite awkward if your partner was never allowed to touch you without having to ask for consent. This can be handled by giving consent beforehand — for instance, asking your significant partner to wake you up with ... well with love. Is such stated consent even needed — can't lovers just hug each other without asking permission? And can such consent even be given? While most people would probably answer "yes" on both questions, there are those who say no on one or even both. The argument goes that even if you consented beforehand, you might be having a bad morning now and not want any contact — there's no way to know until afterwards, and by then it's too late. Others would argue that this extreme defense against sexual oppression becomes oppressive in itself. For implied or generic consent to work, though, it's necessary for those involved to find out what they like. You can consent to "experiment," but in that situation, it isn't clear what you've consented to. There is a lot of controversy over what constitutes an acceptable context for experimentation:
Problems with implied consentThe problem with this is that some people consider others to have given implied consent even when no such implication was intended at all. The most infamous version of this is guys who believe that if a woman is wearing a short skirt (or if she's not wearing a veil) then she's implying that she wants unknown men to stare at her, touch her, or worse. This has given some people (mostly women) a certain aversion to the concept of implied consent.
Consent and Implied Consent - MedicineImplied consent is also a legal term in medicine. This applies to the United States, and your local laws may be different. A full discussion of this is way beyond the scope of this article, but these kinds of dramatic life-and-death situations come up in fiction and so are worth examining. First, all medical procedures - period - require informed consent. A rational patient must be provided reasonable information about proposed interventions and also must be allowed to refuse care. However, when a patient cannot make decisions for themselves rationally, they have given the health care worker or rescuer implied consent to go ahead and execute appropriate care. If you are dying, and you are in your right mind, you can still wave-away any help and your autonomy in this matter must be recognized. If you fall unconscious before help arrives, your rescuers should assume you wanted help. To be "rational," you must be an adult or emancipated minor, must be judged to be able to make sound decisions, and must not be in some form of altered mental status such as intoxicated or unconscious. The classic example is when a paramedic finds a patient knocked out in a car accident and heavily injured, he does not have to wait for the patient to come to before beginning treatment and evacuation. A heroin addict who is semi-conscious cannot wave-away treatment for his overdose. A child or a person with schizophrenia cannot make many decisions at all. This leads to problematic situations and as such there are some exceptions. For example, parents cannot deny life-saving treatment to a child because it contradicts the parent's religious views. In this case, the physician is empowered to legally make that decision against the child's and parents' wishes to save that child. When a person's mental state or drug intoxication makes them ineligible to make a rational decision, a physician can be empowered to order treatment despite these objections. All of these situations fall under implied consent, with the idea that a person who looks back on the situation rationally or as an adult would likely consent to receive treatment and so it should be assumed on behalf of those who cannot make the decision themselves. As soon as a person "comes to their senses," they can revoke consent immediately. A patient who is losing consciousness who has not revoked consent continues to give implied consent right until they are out. For example, a patient who has been wheeled to the OR and prepared for surgery could refuse care and be wheeled right out of the OR. Once the patient is under (presumably having not objected while conscious), implied consent governs the entire procedure until the patient awakens again. Likewise, if a complication is discovered, your consent is still needed for the new situation. For example, a patient who is in for an appendectomy is opened and the surgeon discovers a malignancy. The surgeon cannot simply attempt to remove the cancer "while he's in there anyway," and the patient must be informed about the discovery and allowed to give consent to the tumor's removal. You can preemptively revoke consent to certain procedures with an advanced directive, the most famous of which is a DNR (Do Not Resuscitate) order. A patient with an advanced directive has stated their wishes and those must be honored regardless of the outcome or objections from family members. Another strategy for handling these decisions is appointing a surrogate to make decisions for you, such as with a power of attorney. Furthermore, in a few special situations such as getting an abortion or treatment for STDs, a minor does not have to consult their parents and can procure services without their parents' consent. Finally, an advanced directive must be presented before the crisis situation hits and your family cannot simply vouch that you have one (as they may not have your wishes at heart). Without a DNR or power of attorney, medical personnel are assumed to have your implied consent, regardless of what you told your family. Don't just tell your family any end-of-life or emergency care instructions. Put it in writing. There's a few situations where a DNR or advance directive preventing care go out the window. Generally, pre-hospital responders (EMTs, paramedics, even civilian bystanders) aren't bound by it as there's usually no way to verify it in the field and they respond in situations where minutes, even seconds, can count. Some ambulance corps will allow you to file a DNR with them in case they need to respond, but this is far from universal. Also, any overt indication that you want assistance, even in a hospital setting with an advanced directive or power of attorney on file, renders those orders invalid. There is one additional issue here. An extremely popular treatment for autism known as Applied Behavioral Analysis or ABA for short (which happens to be the only autism treatment American health-insurance is required to cover) actually mandates practitioners to violate the patients' consent (though technically a patient younger than 18 can't consent so the parents consent for the patient). ABA holds the dubious distinction of being a treatment method which 100% of first-hand patient testimonials advise against, citing (among other things) Post-Traumatic Stress Disorder and fear of asserting personal boundaries, which in turn can lead to considerable complications concerning credibility of consent in contrasting contexts.
Safe Sane And ConsensualOne of the most popular ways of trying to deal with all these problems is the moral code known as SSC: Safe, Sane, And Consensual.
Problems with SSCNot counting people who try to find semantic loopholes to get around the spirit of the rule while still pretending to uphold it, there are still three problems with SSC:
Risk Aware Consensual KinkTo get away from the previously described problems with SSC, some people in the BDSM community prefer instead to talk about RACK: Risk Aware Consensual Kink. RACK is essentially the same as Informed Consent, but with the added implication that even the most risky and self-destructive behaviors are acceptable, provided that the risks are understood beforehand, and the consent is freely given. This presents its own problems: