It is a truism among medical ethicists that patients or research subjects must do more than merely say “I consent” in order to morally authorize treatment.  Genuine consent must be informed consent.  People need to know what their options are, and at least something about what those various options entail.

Contrast this with the kind of “consent” people talk about in democracies.  Nevermind for the moment the fact that locutions like “the people chose policy X” obscure the fact that some people chose it, while others chose some competing policy.  Nevermind that for most policies (say, US immigration or drug policy), it is exceedingly rare for voters to be presented with a discrete choice regarding that policy at all (as opposed to a choice between candidates who support a bundle of different policies).

Even if or when voters were to face such a discrete choice, we wouldn’t require anything like informed consent from them.  They don’t even need to know who the other candidate is, much less what issues he or she stands for, much less what the empirical evidence supporting or opposing those stances is.

This, despite the fact that political decisions authorize the use of (sometimes deadly) force, surely a serious moral issue if anything is.  And this, despite the fact that political decisions, unlike medical decisions, affect in the first instance not just oneself but other people.  Shouldn’t the stakes be higher, not lower, for non-self-regarding behavior?

So what, if anything, justifies this difference?