Current practices and medico-legal aspects of pre-operative consent

Osime, OC; Okojie, OH; Osadolor, Faith O.; Mohammed, Shimels Hussien

doi:10.4314/eamj.v81i7.9186

Cited by 17 publications

(15 citation statements)

References 7 publications

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“…Akin to this, perhaps, is the apparent undervaluing of medical ethics in surgical training curriculum. Previous studies in postoperative patients have demonstrated the necessity for surgeons to spend more time and provide more information to their patients preoperatively 2 3 11. This is a surgeon's moral obligation and one way to avoid situations where patients are ‘feeling afraid or nervous’12 before surgical operations.…”

Section: Discussionmentioning

confidence: 99%

Surgeons' opinions and practice of informed consent in Nigeria

Ogundiran

Adebamowo

2010

J Med Ethics

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Background Informed consent is perhaps more relevant to surgical specialties than to other clinical disciplines. Fundamental to this concept is the provision of relevant information for the patient to make an informed choice about a surgical intervention. The opinions of surgeons in Nigeria about informed consent in their practice were surveyed. Methods A cross-sectional survey of surgeons in Nigeria was undertaken in 2004/5 using self-administered semistructured questionnaires. Results There were 102 respondents, 85.3% of whom were men and 58.8% were aged 31–40 years. 43.1% were consultants and 54.0% were surgical trainees. 27.4% were in surgical subspecialties, 26.5% in general surgery and 21.6% were obstetricians and gynaecologists. 54.9% agreed that sufficient information is not provided to patients while obtaining their consent for surgical procedures. They listed medicolegal reasons (70.6%), informing patients about benefits, risks and alternatives (64.7%) and hospital policy (50.0%) as some reasons for obtaining consent for surgical procedures. When patients decline to give consent for surgery, 84.3% of them thought that poor communication between surgeons and patients may be contributory. They identified taking a course in bioethics during surgical training and compulsory communication skills course as some ways to improve communication between surgeons and patients. Conclusion Most Nigerian surgeons seemed to have a good knowledge of the informed consent requirements and process but fall short in practice. There is a need to improve the surgeon–patient relationship in line with modern exigencies to provide interactive environments for fruitful patient communication and involvement.

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Section: Discussionmentioning

confidence: 99%

Surgeons' opinions and practice of informed consent in Nigeria

Ogundiran

Adebamowo

2010

J Med Ethics

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“…Could this be due to the increasing awareness of the patients on their right to know and be involved? It has been reported that the desire for patient autonomy and readiness to seek consent is directly related to educational attainment of the patient [8, 11, 14]. Some studies have, however, shown that there may be underestimation of needs by patients for detailed peri-operative information [15–17].…”

Section: Introductionmentioning

confidence: 99%

Attitude towards informed consent practice in a developing country: a community-based assessment of the role of educational status

et al. 2014

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BackgroundIt has been reported by some studies that the desire to be involved in decisions concerning one’s healthcare especially with regard to obtaining informed consent is related to educational status. The purpose of this study, therefore, is to assess the influence of educational status on attitude towards informed consent practice in three south-eastern Nigerian communities.MethodsResponses from consenting adult participants from three randomly selected communities in Enugu State, southeast Nigeria were obtained using self-/interviewer-administered questionnaire.ResultsThere were 2545 respondents (1508 males and 1037 females) with an age range of 18 to 65 years. More than 70% were aged 40 years and below and 28.4% were married. More than 70% of the respondents irrespective of educational status will not leave all decisions about their healthcare to the doctor. A lower proportion of those with no formal education (18.5%) will leave this entire decision-making process in the hands of the doctor compared to those with tertiary education (21.9%). On being informed of all that could go wrong with a procedure, 61.5% of those with no formal education would consider the doctor unsafe and incompetent while 64.2% of those with tertiary education would feel confident about the doctor. More than 85% of those with tertiary education would prefer consent to be obtained by the doctor who will carry out the procedure as against 33.8% of those with no formal education. Approximately 70% of those who had tertiary education indicated that informed consent was necessary for procedures on children, while the greater number of those with primary (64.4%) and no formal education (76.4%) indicated that informed consent was not necessary for procedures on children. Inability to understand the information was the most frequent specific response among those without formal education on why they would leave all the decisions to the doctor.ConclusionThe study showed that knowledge of the informed consent practice increased with level of educational attainment but most of the participants irrespective of educational status would want to be involved in decisions about their healthcare. This knowledge will be helpful to healthcare providers in obtaining informed consent.

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“…The current consent process prior to a procedure involves a physician and/or medical staff member verbally explaining a procedure, its risks and its benefits to a patient. This process is inadequate, 1–5 inconsistent among physicians obtaining informed consent, 6,7 and variably comprehensible among patients with different educational levels 8 . Incomplete informed consent can result in poor legal outcomes for physicians 4 and cause anxiety and confusion among patients.…”

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confidence: 99%

Portable video media for presenting informed consent and wound care instructions for skin biopsies: a randomized controlled trial

Armstrong

Alikhan

Cheng

et al. 2010

British Journal of Dermatology

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SummaryBackground In fast-paced dermatology clinics, the process of obtaining informed consents for biopsies and providing postprocedure instructions may be incomplete and inconsistent. Objectives To compare effectiveness of video-based education with that of verbal education for giving informed consent and providing postprocedure wound care instructions in patients undergoing skin biopsies. Methods In this randomized controlled trial, participants were randomized to receive either video education on portable video devices or conventional verbal instructions regarding skin biopsies. Participants completed a skin-biopsy knowledge assessment, patient satisfaction assessment and evaluation of educational medium. Main outcome measures were differences in the changes in the prestudy and poststudy knowledge assessment scores, patient satisfaction and evaluation of the educational medium. Results Eight-four patients undergoing skin biopsies at the University of California Davis dermatology clinic participated in the study. Participants in the control group had a nonstatistically significant increase in knowledge score (mean ± SD 1AE12 ± 1AE74), whereas those in the video group had a statistically significant increase in knowledge score (mean ± SD 1AE55 ± 1AE71). The difference in knowledge scores between the video and verbal groups was not statistically significant. Participants in both groups were highly satisfied with the biopsy education. On a 10-point scale, the mean ± SD usefulness and appeal of the videos were 9AE01 ± 1AE5 and 9AE01 ± 1AE66, respectively. Conclusions Our study demonstrated a significant increase in knowledge score following video education, but not following oral education. Although betweengroup comparisons did not achieve statistical significance, portable video media for presenting informed consent and wound care instructions for skin biopsies appear to be more effective and result in higher satisfaction than traditional oral education.

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Current practices and medico-legal aspects of pre-operative consent

Cited by 17 publications

References 7 publications

Surgeons' opinions and practice of informed consent in Nigeria

Surgeons' opinions and practice of informed consent in Nigeria

Attitude towards informed consent practice in a developing country: a community-based assessment of the role of educational status

Portable video media for presenting informed consent and wound care instructions for skin biopsies: a randomized controlled trial

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