Problems related to informed consent in surgery and recommendations

Abstract

Aydinlatilmi § onam, her bireyin kendi bedenine yapilacak olan her türlü tibbi uygulamayi bilme ve belirleme hakkina sahip oldugu görü §ünu temel alan bir kavranidir. Aydinlatilmi § onam hakkinda gunûmûze kadar pek cok ulusal ve uluslararasi düzenleme yapildigi gorûlmèkte, ancak bu dûzenlemelere ragmen halen uygulamada hem mevzuatin yeterince bilinmemesinden, hem de sorunun hukuki ve tibbi yönlerinin birlikte ele alinmamasindan ötürü yanli §liklarla kar §ila §ilmaktadir. Bu yazida, özellikle cerrahi uygulamalarda aydinlatilmi § onamla ilgili olarak sikça ortaya çikan sorunlar belirlenmi § ve bu sorunlarin giderilmesi amaciyla cözüm önerileri sunulmu §tur.

The Nurse's Role and Responsibilities in Informed Consent: Review

“…6,8,9,10 Sağlık çalışanlarının konu hakkındaki mevzuatı yeterince bilmemelerinin yanı sıra, kimin tarafından aydın-latılmış onam alınacağına karar verememeleri, hangi uygulamalarda yazılı-sözlü onam alınacağını belirleyememeleri ve onam almadan tedavi uygulamaları gibi sorunlar da yasal açıdan sağlık çalışa-nının sıkıntı yaşamasına sebep olmaktadır. 8,11 Aydınlatılmış onamın amacı, yasal zorunluluk ya da kurumun politikası olmamalı, hastayı korumak üzere geliştirilmesi, kurum ve sağlık hizmeti sunucuları arasında açık ve dürüst iletişim kurmayı içermesi gerekmektedir. Hasta karar verme sürecinin içinde yer almalı, sağlık hizmet sunucuları ile birlikte tartıştık-ları ve karara vardıkları bir süreci içermelidir.…”

Ethical Assessment of Blank Consent Forms for Medical Interventions in a Training and Research Hospital in Turkey

“…While there is no consensus regarding definitions of many issues in medical ethics, informed consent has had relatively standard ethical, legal, and institutional definitions in national and international regulations for a long time (3). However, probably based on the difference between the theory and application of the informed consent process (4), there are still controversies regarding informed consent.…”

“…In Turkey, there are no requirements concerning the form of informed consent needed for medical interventions, except for cases included in specific legislation, such as major surgical procedures, pregnancy termination, organ transplantation, and genetic testing (3). Nevertheless, the informed consent process in Turkey typically entails obtaining a signed written consent form in which the focus is on explaining the risks of the procedure.…”

How informed are endocrine surgery patients about the risks of surgery after approving an informed consent?

“…The validity of a consent that is obtained immediately before the procedure and prepared in a different and complex language beyond comprehension of people is controversial. Tümer stated in their article entitled ''Informed Consent and Related Issues and Proposed Solutions'' that was published in the National Surgical Journal that the informed consent should be obtained by the physician who will perform the procedure, that all the information should be explained clearly and understandably at least 24 hours prior to the surgical procedure, except for emergency surgery, in order to ensure the patient's making a reasonable and appropriate assessment (6). In our study, 9 of 10 patients stated the time given to fill the consent forms was enough, 75% read the form 1-2 days prior to surgery and the remaining patients read and signed the form just before surgery.…”

“…This in turn will strengthen the physician-patient relationship, as well as a facilitative effect in solving undesirable situations that may arise later (6). The outpatient physician informed each patient who has applied to the Endocrine Surgery outpatient clinic and had an indication for surgery orally, and then informed consent and disclosure forms were handed out to the patient.…”