Informed consent: A patients' perspective

Department of Otolaryngology, Head and Neck Surgery, Royal Victoria Eye and Ear Hospital, Adelaide Road, Dublin, Ireland.
The Journal of Laryngology & Otology (Impact Factor: 0.67). 02/2005; 119(1):19-22. DOI: 10.1258/0022215053222860
Source: PubMed


The medico-legal issues surrounding informed consent are highly topical and contentious. Current attitudes to consent emphasize the high level of 'good medical practice' expected by a 'reasonable patient/parent'. The authors' objectives were to assess the levels of knowledge and information expected by patients and parents, prior to signing consent forms for a surgical procedure. Each patient or parent was asked a series of questions prior to signing a consent form. Answers were recorded on a standard questionnaire. More than 80 per cent of respondents were happy with the information provided in out-patients, however, over half of these could not list even one complication of their operation. Two-thirds of those surveyed sought information elsewhere, while over half expected to be informed of all known complications, even if the rate of complications was less than one per cent. In conclusion, the information provided by surgeons might not meet the expectations of today's informed patients.

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Available from: Ivan James Keogh, Apr 01, 2015
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    • "The law is unclear as to precisely how much information healthcare professionals must provide a patient. There is certainly evidence within the literature that patients have much greater expectations about the amount of information they believe they should be given by those responsible for their healthcare treatment than can be the reality [Burns et al, 2005]. The Irish courts have provided some guidance regarding the amount of information healthcare professionals must give a patient as required by law. "

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    • "Over half of their patients wished to be informed of a risk of 1 in 1000. In a study by Burns et al (2005), nearly three quarters of patients expected to be informed of all known complications even if the rates were less than 1%. However, when questioned postoperatively, over half could not list even one complication of the procedure. "
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    ABSTRACT: To ascertain the level of information relating to specific risks desired by patients prior to cataract surgery. Dedicated cataract surgery pre-assessment clinics of 2 hospitals in South West Wales, UK. Consecutive patients (106) were recruited prospectively. Of these, 6 were formally excluded due to deafness or disorientation. Eligible patients (100) were asked a set of preliminary questions to determine their understanding of the nature of cataract, risk perception, and level of information felt necessary prior to giving consent. Those who desired further information were guided through a standardized questionnaire, which included an audio-visual presentation giving information relating to each potential surgical complication, allowing patients to rate them for relevance to their giving of informed consent. Of the entire group of 100, 32 did not wish to know "anything at all" about risks and would prefer to leave decision making to their ophthalmologist; 22 were interested only in knowing their overall chance of visual improvement; and 46 welcomed a general discussion of possible complications, of whom 25 went on to enquire about specific complications. Of these 25, 18 wished to be informed of posterior capsular (PC) tearing, 17 of endophthalmitis, 16 each of dropped lens, retinal detachment and corneal clouding, and 15 of bleeding, sympathetic ophthalmia, and PC opacification. Patients differ in their desire for information prior to cataract surgery, with one significant minority favoring little or no discussion of risk and another wishing detailed consideration of specific risks. A system of consent where patients have a choice as to the level of discussion undertaken may better suit patients' wishes than a doctor-specified agenda.
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    ABSTRACT: Um total de 100 pacientes foram entrevistados através da utilização de um questionário padrão antes de qualquer procedimento cirúrgico no departamento de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço do Hospital Universitário da Tribhuvan University entre setembro e novembro de 2006. Todas as questões foram respondidas de forma escrita. Os formulários foram analisados utilizando- se de método manual simples usando freqüência e porcentagem. Resultados: A maioria (96.0%) dos pacientes ficou satisfeita com a informação dos médicos assistentes sobre o procedimento cirúrgico, antes de serem submetidos à cirurgia. Entretanto, 8.0% dos entrevistados procuraram mais informações através da internet, revistas e conversas com pacientes previamente operados. O tempo médio de espera para cirurgia foi de 4.2 meses. Em torno de 77.0% dos pacientes não foram relatadas quaisquer complicações. Informações sobre qualquer complicação cirúrgica conhecida foi solicitada por 90% dos pacientes. Conclusão: As expectativas dos pacientes foram altas e a maioria procurou ser informada acerca de qualquer complicação cirúrgica conhecida. Apesar do questionamento se o termo de consentimento deve conter todas as informações sobre o procedimento cirúrgico, o mesmo deve conter todas as principais complicações cirúrgicas. Palavras-chave: consentimento informado, expectativa, procedimento cirúrgico. SUMMARY Objective: To observe the information expected by patients/caretakers before signing consent form for different ENTsurgical procedures. Methods: Altogether 100 patients were interviewed with a standard questionnaire prior to any surgical procedure in department of ENT and Head and Neck Surgery of TU Teaching Hospital from September to November 2006. All questions were answered in written form. These records were analyzed by simple manual analysis using frequency and percentage. Results: Majority (96.0%) of patients were satisfied with the information given by doctors about their surgical procedure before doing surgery. However, 8.0% respondents looked for further information regarding their surgery in internets, various magazines, and talking to previously operated individuals. The mean waiting time for surgery was 4.2 months. There were 77.0% patients who could not list any complications. Ninety percent want to be informed about all known complications. Conclusion: Patients' expectation was quite high and majority of them wanted to be informed about all known complications. Whether Informed consent should include all the information regarding the surgical procedure is still debatable. However, it must include major complications after surgery.
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