Informed Consent In Health Care

Patient’s  Demand or Legal Requirement 

    Patients facing major surgery may be reluctant to acknowledge the difficulties in understanding complex clinical procedures. Informed or shared decision-making protocols aim to provoke and address these feelings so that patients who consent to surgery know what they are agreeing to. 

ACS and Study

    However, a new study in the Journal of the American College of Surgeons found that surgeons are less likely to address patients’ decision-making needs than to cover elements of consent, such as: 

The nature of the disease, the details of the surgical procedures and possible complications. 

Surgeon Behavior and Reponses of Patient During Conversation 

    In an analysis of 90 patient-surgeon conversations about high-risk cardiothoracic, vascular, oncology, and neurosurgical procedures, researchers found that surgeons were less likely to rate how well patients understood these consent conversations and the role patients played in the decision to their everyday life, their preferences and their personal insecurities. 

Discussion

    However, when final decisions about surgery were deferred, researchers found that surgeons were more likely to focus on elements of informed decision-making, such as uncertainty and treatment alternatives. The course of these conversations did not appear to be affected by factors such as the presence of family members, patient history, location, or the surgeon’s specialty. 

    The study authors acknowledged that informed consent has been part of medical practice much longer than the concept of informed decision-making, so the finding that surgeons perform better at consent was not surprising. 

    However, co-author Susan C. Pitt, an assistant professor of surgery at the University of Wisconsin School of Medicine and Public Health, said formal training in informed consent and decision-making is necessary in medical education. 

    “I know some training programs already have formal processes and training, but they are not ubiquitous,” he told AJN. “I also believe that quality standards can be set, measured and monitored with a feedback system around the consent process.” Pitt emphasized the role of nursing in patient consent and decision-making processes. 

    “Nurses are part of the care team and can help educate and prepare patients for what recovery and life after surgery will be like,” he said, adding that with patients with complex issues, nurse-navigators are particularly well-placed to help to guide these patients through the surgery decision-making process. – Roxanne Nelson

Results or Reading Output

Surgeons focus on consent protocols rather than patient decision-making needs.