A survey of the current practice of the informed consent process in general surgery in the Netherlands

Abstract

BackgroundA properly conducted surgical informed consent process (SIC) allows patients to authorize an invasive procedure with full comprehension of relevant information including involved risks. Current practice of SIC may differ from the ideal situation. The aim of this study is to evaluate whether SIC practiced by Dutch general surgeons and residents is adequate with involvement of all required elements.MethodsAll members of the Dutch Society of Surgery received an online multiple choice questionnaire evaluating various aspects of SIC.ResultsA total of 453 questionnaires obtained from surgeons and residents representing >95% of all Dutch hospitals were eligible for analysis (response rate 30%). Knowledge on SIC was limited as only 55% was familiar with all three basic elements (‘assessment of preconditions’, ‘provision of information’ and ‘stage of consent’). Residents performance was inferior compared to surgeons regarding most aspects of daily practice of SIC. One in 6 surgeons (17%) had faced a SIC-related complaint in the previous five years possibly illustrating suboptimal SIC implementation in daily surgical practice.ConclusionsThe quality of the current SIC process is far from optimal in the Netherlands. Surgical residents require training aimed at improving awareness and skills. The SIC process is ideally supported using modern tools including web-based interactive programs. Improvement of the SIC process may enhance patient satisfaction and may possibly reduce the number of complaints.

An audit of the knowledge and attitudes of doctors towards Surgical Informed Consent (SIC)

“…Our study identified considerable deficiencies in the current knowledge and attitudes of our doctors toward this very crucial area of doctor-patient communication. Surprisingly certain studies from institutions in the western countries such as the USA, Europe, Netherlands and New Zealand have also reported a lack of doctors' knowledge regarding the process of SIC (1,3,(7)(8)(9)(10). Less than ideal level of working knowledge and attitudes regarding SIC on part of our doctors indicates a case for their focused education regarding SIC.…”

“…The aim was to cover all fundamental aspects of the knowledge and relevant attitudes that surround the process of SIC and hence generate a representative data that could serve as a valid outcome variable. The questionnaire was prepared by consulting previously used and validated questionnaires employed by other researchers (3,(5)(6)(7)(8).…”

“…The preconditions for a valid SIC include the patient's competence and voluntariness for the procedure in question. The information provided must be adequate and comprehensible (1)(2)(3). The information provided should particularly include medical facts about the patient's condition, details of the proposed procedures, the potential risks and benefits of the procedure and the alternatives to the proposed procedure including the natural course of non-treatment.…”

“…All this information must be disclosed by the operating surgeon himself to the patient to help him arrive at informed decision-making about his treatment. A well-defined care plan incorporating the surgeon's advice should be discussed and it must be ensured that the patient understands all this information (3)(4)(5)(6). The objective of the present study was to audit the current knowledge and attitudes of surgical doctors towards the SIC at a tertiary care teaching hospital in a Pakistan.…”

The relationship between knowledge and perception of patients regarding informed consent in surgical procedures in Rwanda

“…The patient has the right to obtain enough information regarding surgical procedures options. 1,2 In the twentieth century, the informed consent had been recognized as an issue in surgical health care services. 3 Informed consent is built on patient competence to understand information and making a deliberate decision to undergo a specific surgical procedure and is valid until the patient' disease has not been changed or no new findings that may change the planned procedure are revealed.…”