Which element of informed consent concerns the patient making a decision free from coercion?

• A. Competence
• B. Voluntary decision
• C. Comprehension of information
• D. Disclosure of risks/benefits/alternatives

Answer: (B)

Voluntary decision is the element that ensures the patient makes a choice free from pressure or manipulation. Informed consent rests on four aspects: providing information (disclosure of risks, benefits, and alternatives), the patient’s understanding of that information (comprehension), the patient’s capacity to decide (competence), and the decision being made without coercion (voluntariness). Even if someone understands the information and has the capacity to decide, coercion or undue influence would invalidate the consent because it compromises autonomy. For example, if a clinician pressures a patient by threats or manipulative tactics, the decision isn’t truly voluntary, and the consent isn’t valid. The other elements focus on how information is delivered and understood, or whether the person has the ability to decide, rather than on freedom from coercion.