For lots of reasons, but mostly, because it feels very bureaucratic, like it introduces something into the room, into the relationship, other than our relationship.
At its purest, I like the relationship to feature nothing other than words in the room spoken back and forth. Of course, the world has reality in it, but anything other than that, I like to think about, and to avoid when possible. Although I drink water in session, and provide water, my theoretical perspective is that even that detracts from (our access to) feeling.
On a more prosaic level: a form is, practically, and legally, just evidence of an agreement. Do I really need evidence from my patients of anything? What am I arming myself against? Them? The state? What does it communicate if I say to them, “I want to have evidence from you that we agreed on x”?
I can argue the opposite: that it’s effective communication to lay out certain terms of agreements in writing. I’m not saying that’s wrong. I’m just saying that, for the kind of relationships I want to have with my patients, I really like to memorialize as much of it as possible in spoken communication – and then, in moments when there are disagreements, to talk about that.
So, I suppose, maybe this is the simplest way of saying it:
You ask “How come I don’t like them?” I think the question should be the opposite way ’round: before doing anything in a clinical context, the question should be, “Why am I doing this? What am I getting by doing it? What might I be giving up?”
When I ask those questions around things like “informed consent,” it feels like a no-brainer, for me. [Not, by any means, for everyone.]
