Informed consent for invasive medical procedures is not routinely obtained (AJRCCM 2003; 167: A105). We examine patients’ perspectives regarding consent with three questions: 1. Do patients want to give informed consent for invasive medical procedures, 2. What frequency of complications do patients think should require consent, and 3. Do patients recall elements of the admission general consent-to-treat?
Adult patients admitted to a 325-bed hospital for acute medical or surgical problems were interviewed using a questionnaire. Responses were examined to determine differences based on age, gender, educational level and ethnicity.
Two hundred sixty five patients (132 men and 133 women, ranging in age from 19 to 97 years; mean± SE=64.4± 1.0 years) participated in the study. The majority (58%) of patients wanted to consent for medical procedures. Amongst patients who felt that they should give consent, most felt that procedures with small or non-serious risks should not require written consent. For procedures with potentially serious risks in up to 1% of cases, 28% wanted to consent. This study also demonstrates that most (94% of) patients did not sign, did not read or did not recall properly the admission consent-to-treat.CONCLUSIONS: This study demonstrates that most, but not all, patients want to consent for procedures and they feel the general consent to treat is not adequate. There is a mismatch of patients’ expectations (and regulatory/legal standards) of consent and that being practiced “in the field.”
Consensus is required to provide a clear binding standard for practitioners, based on ethical principles of respect of patient autonomy, while recognizing the very real logistics of patient care and the need that such standards not impede prompt and optimal medical therapies.
N. Thorevska, None.