A survey on surgeons' perceived quality of the informed consent process in a Swiss paediatric surgery unit

Abstract

AimTo evaluate the levels of satisfaction and opinions on the usefulness of the informed consent form currently in use in our Paediatric Surgery Department.Materials and methodsDesign: Qualitative study carried out via interviews of senior paediatric surgeons, based on a questionnaire built up from reference criteria in the literature and public health law.ResultsPhysicians with between 2 and 35 years experience of paediatric surgery, with a participation rate of 92 %, agreed on the definition of an informed consent form, were satisfied with the form in use and did not wish to modify its structure. The study revealed that signing the form was viewed as mandatory, but meant different things to different participants, who diverged over whom that signature protected. Finally, all respondents were in agreement over what information was necessary for parents of children requiring surgery.ConclusionPaediatric surgeons seemed to be satisfied with the informed consent form in use. Most of them did not identify that the first aim of the informed consent form is to give the patient adequate information to allow him to base his consent, which is a legal obligation, the protection of physicians by the formalisation and proof of the informed consent being secondary. Few surgeons brought up the fact that the foremost stakeholder in paediatric surgery are the children themselves and that their opinions are not always sought. In the future, moving from informed consent process to shared decision-making, a more active bidirectional exchange may be strongly considered. Involving children in such vital decisions should become the norm while keeping in mind their level of maturity.

A survey on patients’ knowledge and expectations during informed consent for spinal surgery: can we improve the shared decision-making process?

“…Informed medical consent is crucial and goes far beyond signing a form [ 5 ]. Nowadays this is put more to the physicians’ attention because of a dramatic emergence in medico legal processes [ 6 ]. Joolaee S. et al reported that 48 % of the patients did not even read the form before signing [ 7 ].…”

Termo de consentimento informado: entendimento do paciente cirúrgico

“…(12) Many patients have limited understanding about the implications of the FICF, and are unable to understand that the document protects their interests and enables them to exercise autonomy. (13) In this study, it was found that the vast majority of participants agreed that the FICF had plain language and clear information. This is in contrast to another study, in which the FICF presented a high degree of difficulty reading.…”

“…One of the reasons reported for not reading and only signing the FICF without requesting explanation of the information contained in it were: fear of reading it and finding out the risks that they would be subject to, hurry to complete the bureaucratic part of hospitalization to perform the procedure as soon as possible, and fear of not signing and not being cared for or operated on, among other factors listed as the reason to merely sign it (without reading). (13) On the basis of their higher level of knowledge, it is possible that the physician implicitly exercises on their patient an involuntary psychic duress, making the patient feel embarrassed to read the document and sign it anyway. (21) When asked if they knew the function of the FICF, 28.9% disagreed.…”