Valerie Gutmann Koch, Co-Director and Assistant Professor of Health Law & Policy Institute
July 14, 2023 — Valerie Gutmann Koch, Co-Director and Assistant Professor of the Health Law & Policy Institute at the University of Houston Law Center, has been selected as a 2023-24 Faculty Fellow. The award is presented annually by the Elizabeth D. Rockwell Center on Ethics and Leadership at the Hobby School of Public Affairs to UH faculty to pursue “research projects on ethics and/or leadership.”
Passionate about bioethics and the law, Koch will examine how to ensure the legal doctrine of informed consent reflects the ethical goals that underly it.
“I am thrilled to receive this award, and I am really excited to be able to do an even deeper dive into a subject area that I have been fascinated by for a very long time,” Koch said. “This award really enables me to devote my time to a project that I am passionate about.”
Koch’s proposed project, “Reimagining Informed Consent,” emphasizes the bioethical principle of justice, which is often ignored at the expense of autonomy (the freedom to make decisions) and beneficence (the desire to do good) and is swept away by circumstance.
“Hearing about the incredible experiences had by other members of the Law Center faculty prompted me to try for the fellowship,” Koch said. “My entire academic career is focused on the ethics of medicine, and the leadership element of being able to work toward something better, made this too good of an opportunity to pass up.”
The Faculty Fellows award provides Koch with $24,000 to continue her studies on the legal doctrine of informed consent. As such, Koch proposes a new rule that includes an element of comprehension into the tort of informed consent, which has historically focused solely on disclosures.
“In previous scholarship, I have explored different ways to address the deficiencies of the legal doctrine of informed consent,” Koch said. “I have even explored eliminating liability for failure of informed consent. Ultimately, I concluded that it was not time to do that. The legal doctrine of informed consent is still effective in some ways and exists to protect patients and allow for autonomous decisions.”
Koch noted that a large facet of her current research hinges on information comprehension. By assessing tools necessary to ensure comprehension and identify the most effective methods to measure understanding, policymakers and physicians can rely on these tools to ensure that patients are able to make informed, voluntary decisions.
Currently, the law looks only at what the physician discloses to a patient but not what is understood. “I think it is important to ask, ‘Do patients actually understand those disclosures?’” Koch questioned. “Because only if they understand those disclosures can they actually make informed decisions.”
Already she is exploring model statutory language to make this proposal to state legislators. “This fellowship enables me to begin work drafting model legislation, engage in a deeper dive of tools and techniques for ensuring understanding, and consider the concerns around inequities that are inherent to the informed consent process today,” Koch said.
“It is also important that we think about the fact that inconsistent health literacy, language barriers and racial inequities are inherent in the medical system,” Koch said. “That means that poor informed consent is going to disparately impact certain populations. Hopefully, my proposal will help to ameliorate some of these inequities that are endemic to informed consent.”
Raised by two doctors, Koch was fascinated by the doctor-patient relationship early on. Her work recognizes that everyone has or will be a patient or a caregiver in their lives, and these roles are not specifically exclusive.
