Abject or Autonomous? Patient Consent to Psychoanalytic Treatment: Informed Consent to Psychoanalysis: The Law, the Theory, and the Data. By Elyn R. Saks and Shahrokh Golshan. New York:  Fordham University Press, 2013,  xii pages + 127 pp., $75.00 hardcover, $24.00 paperback.

The patient's reliance on the physician is a trust of the kind which traditionally has exacted obligations beyond those associated with arms-length transactions. His dependence on the physician for information affecting his well-being, in terms of contemplated treatment, is well-nigh abject.

Professors Elyn Saks and Shahrokh Golshan have given us a fascinating and eye-opening account of the legal, theoretical, and empirical dimensions of informed consent to psychoanalysis. The issue of informed consent provides a perfect case study for exploring the enduring—and in the authors' skillful hands, captivating—question of the interrelationship between law and psychoanalysis. The two disciplines appear irreconcilable in so many ways, and at first glance would seem to offer very different perspectives on the meaning of informed consent. Law posits the existence of a rational, autonomous subject knowingly and consciously deciding whether to undergo psychoanalytic treatment. Psychoanalysis, by contrast, offers a portrait of the patient whose abject suffering makes the prospect of informed consent to psychoanalysis nearly impossible. Yet upon examination, the two disciplines may not actually offer such differing perspectives on the issue of patient consent after all. Saks and Golshan lead us to consider whether the fundamental right of patient autonomy binds the two disciplines together, psychoanalysis and law, in a shared appreciation for the ideal of individual self-determination.