In obtaining informed consent for bone marrow transplantation (BMT) oncologist-investigators may feel that they engender emotional distress in patients due to the disclosure of potentially lethal complications associated with BMT. However, little is known regarding the psychological profile of BMT patients at the time of informed consent or what impact the consent process has upon the physician-patient relationship. The purpose of this study was to assess (1) the psychological symptom profile of patients consenting to BMT and (2) the relationship of behavioral and psychological factors to patients' perceptions of the quality of communication between physician and patient. The results indicated that adult BMT patients experienced significant psychological distress at the time at which they provided written consent for BMT. Two factors were positively related to perceived quality of communication between physician and patient: problem-focused coping style and perceived autonomy in decision making. These findings are interpreted in relation to the goals of informed consent and its implications for the physician-patient relationship.