Hostname: page-component-cd9895bd7-jn8rn Total loading time: 0 Render date: 2024-12-24T01:16:10.986Z Has data issue: false hasContentIssue false

The changing face of informed surgical consent

Published online by Cambridge University Press:  04 November 2011

J C Oosthuizen*
Affiliation:
Department of Otorhinolaryngology, Head and Neck Surgery, The Royal Victoria Eye and Ear Hospital, Dublin, Ireland
P Burns
Affiliation:
Department of Otorhinolaryngology, Head and Neck Surgery, The Royal Victoria Eye and Ear Hospital, Dublin, Ireland
C Timon
Affiliation:
Department of Otorhinolaryngology, Head and Neck Surgery, The Royal Victoria Eye and Ear Hospital, Dublin, Ireland
*
Address for correspondence: Mr J C Oosthuizen, Department of Otorhinolaryngology, Head and Neck Surgery, The Royal Victoria Eye and Ear Hospital, Adelaide Road, Dublin D2, Ireland E-mail: [email protected]

Abstract

Objectives:

To determine whether procedure-specific brochures improve patients' pre-operative knowledge, to determine the amount of information expected by patients during the consenting process, and to determine whether the recently proposed ‘Request for Treatment’ consenting process is viable on a large scale.

Method:

A prospective, questionnaire-based study of 100 patients admitted for selected, elective surgical procedures.

Results:

In total, 99 per cent of patients were satisfied with the information received in the out-patient department, regarding the proposed procedure. However, 38 per cent were unable to correctly state the nature of the surgery or specific procedure they were scheduled to undergo. Although the vast majority of patients were able to state the intended benefits to be gained from the procedure, only 54 per cent were able to list at least one potential complication, and 80 per cent indicated that they wished to be informed about all potential complications, even if these occurred in less than 1 per cent of cases.

Conclusions:

The introduction of procedure-specific brochures improved patients' pre-operative knowledge. Although the failings of current consenting practice are clear, the Request for Treatment consenting process would not appear to be a viable alternative because of the large number of patients unable to accurately recall the nature of the proposed surgery or potential complications, following consent counselling.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Shokrollahi, K. Request for treatment: the evolution of consent. Ann R Coll Surg Engl 2010;92:93100CrossRefGoogle Scholar
2Wheeler, R. The evolution of consent. Ann R Coll Surg Engl 2010;92:91–2CrossRefGoogle Scholar
3Burns, P, Keogh, I, Timon, C. Informed consent: a patients' perspective. J Laryngol Otol 2005;119:1922CrossRefGoogle ScholarPubMed
4Berry, MG, Unwin, J, Ross, GL, Peacock, E, Juma, A. Ann R Coll Surg Eng 2007;89:368–73CrossRefGoogle Scholar
5Janssen, NBAT, Oort, FJ, Fockens, P, Willems, DL, de Haes, HCJM, Smets, EMA. Under what conditions do patients want to be informed about their risk of a complication? A vignette study. J Med Ethics 2009;35:276–82CrossRefGoogle ScholarPubMed
6Ross, N. Improving surgical, consent. Lancet 2004;364:812–13CrossRefGoogle Scholar
7Wiseman, OJ, Wijewardena, M, Calleary, J, Masood, J, Hill, JT. ‘Will you be doing my operation doctor?’ Patient attitudes to informed consent. Ann R Coll Surg Engl 2004;86:462–4CrossRefGoogle ScholarPubMed
8Bowden, MT, Church, CA, Chiu, AG, Vaughan, WC. Informed consent in functional endoscopic sinus surgery: The patient's perspective. Otolaryngol Head Neck Surg 2004;131:126–32CrossRefGoogle ScholarPubMed
9Stanley, BM, Walters, DJ, Maddern, GJ. Informed consent: How much information is enough? Aust N Z J Surg 1998;68:788–91CrossRefGoogle Scholar
10Kerrigan, DD, Thevasagayam, RS, Woods, TO. Who's afraid of informed consent? BMJ 1993;306:298300CrossRefGoogle ScholarPubMed
11Fink, AS, Prochazka, AV, Henderson, WG, Barenfeld, D, Nyirenda, C, Webb, A et al. Enhancement of surgical informed consent by addition of repeat back. A multicenter, randomized controlled clinical trial. Ann Surg 2010;252:2736CrossRefGoogle Scholar
12Bollschweiler, E, Apitzsch, J, Obliers, R, Koerfer, A, Mönig, SP, Metzger, R, Hölscher, AH. Improving informed consent of surgical patients using a multimedia-based program? Results of a prospective randomized multicenter study of patients before cholecystectomy. Ann Surg 2008;248:205–11CrossRefGoogle ScholarPubMed
13Fink, AS, Pochazka, AV, Henderson, WG, Bartenfeld, D, Nyirenda, C, Webb, A et al. Predictors of comprehension during surgical informed consent. J Am Coll Surg 2010;210:919–26CrossRefGoogle ScholarPubMed