AN AUDIT OF INFORMED CONSENT IN SURGICAL PATIENTS AT A UNIVERSITY HOSPITAL
AbstractBackground: To obtain informed consent is considered an integral part of modern clinicalpractice. It works as a safeguard of patient’s rights and minimizes the chances of legal actionagainst the physician in case of any complication arising from the proposed therapy. Objectivewas to evaluate the practice of informed consent in patients undergoing surgery in a Universityhospital. Methods: A survey was conducted at different surgical departments of a universityhospital during December 2007 to March 2008. Participants were selected from patients over theage of 18 years who had undergone elective or emergency surgery. All interviews were based onstructured questionnaire. The patients were asked if an informed consent was taken or not beforethe surgery. They were also inquired if they were given information about the diagnosis, thesurgical procedure planned and risks associated with it. The patients were also asked if they wereinformed about the types of anaesthesia proposed. Results: A total of 106 patients were randomlyselected for this study. In 8.5% cases, no consent was taken. Only 38% of the surveyed patientsacknowledged that they actually understood the information imparted to them. 66% patients wereinformed about the type of anaesthesia proposed but none was given any hint about complicationsof anaesthesia. 11% patients actually signed the consent forms themselves. Conclusion: Thequality of existing informed consent process in a university hospital is less than ideal. There is agreat need to educate the doctors and healthcare regarding the importance of patient’s autonomyand their right to the information about their medical condition and the proposed surgicalprocedures to ensure their participation in the decision making regarding their treatment.Keywords: Informed consent, audit, postoperative patients
American Medical Association: Code of Medical Ethics:
Current Opinions with Annotations. Chicago, American
Medical association, Council on Ethical & Judicial Affairs,
Lidz CW, Meisel A, Osterweis M, Holden JL, Marx JH,
Muntez MR. Barriers to informed consent. Ann Intern Med
Applebaum PS, Grisso T. Assessing patient’s capacities to
consent to treatment. N Engl J Med 1988;99:539–43.
Laura WR. Informed Consent and the Capacity for
Voluntarism. Am J Psychiatry 2002;159:705–12.
Quadrelli S, Colt HG, Lyons G, Cohen D. Respect for
autonomy. How much do patients want to know in order to
make decisions? Medicina 2008;68(3):198–204.
Berg JW, Appelbaum PS, Lidz CW, Parker L. Informed
consent: legal theory and clinical practice. 2nd ed. New York:
Oxford University Press; 2001.
Wears S. Informed consent: patient autonomy and physician
beneficence within clinical medicine. Dordrecht: Kluwer
Academic Publishers; 1993.
Beauchamp TL, Childress JF. Principles of biomedical
ethics. New York: Oxford University Press; 1994.
Amin MF, Jaaid M, Mudassir S, Hina, Zakai SB. An audit of
information provided during preoperative informed consent.
Pak J Med Sci 2006;22(1):10–3.
Vessey W, Siriwardena. Informed consent in patients with
acute abdominal pain. Br J Surg 1998;85(9):1278–80.
Perez-Moreno JA, Perez Carceles MD, Osuna E, Luna A.
Preoperative information and informed consent in surgically
treated patients. Rev Esp Anestesiol Reanim 1998;45(4):130–5.
Marco EL, Chris JM, Justin CN, Adrian WP. Is informed
consent in cardiac surgery and percutaneous coronary
intervention achievable? ANZ J Surg 2007;77(7):530–4.
Adhikari P, Guragain RPS. Patient’s perspective on informed
consent in ear surgery. J Institute Med 2007;29(3):18–20.
Jafarey A. Informed consent: views from Karachi. La Revue de
Sante de la Mediterranee Orientale 2006;12(suppl 1):50–5.