A survey on current practice of informed consent process in surgical specialties of a tertiary teaching hospital center: What is the state of play?
Research Article
Ana Luísa Vieira, Cândida Infante, Sérgio Santos, Mariana Asseiro, Celine Ferreira
Research Square, 1 December 2021
Abstract
Background
Informed consent is essential in current medical practice and should be a global standard to be sought at all instances when doctors interact with patients. The aim of this study was to evaluate compliance to the guidelines of the Portuguese health entity regarding the correct filling process of informed consent.
Methods
A prospective observational survey was conducted upon arrival of the patient at the operating room of a tertiary teaching hospital center in Portugal, in march 2021, to verify the presence of informed consent in the clinical process. A sample of 202 clinical files was randomly collected.
Results
Only 47% of the patients had the informed consent document in the clinic process and only 45% of the total clinical files had the informed consent signed by the patient. Merely 21.8% of the informed consents respected all the items recommended by the guidelines of the Portugal health entity. Most of the surgical informed consent (SIC) had only basic information and only a lower percentage had reports about the surgical procedure, information regarding the treatment, possible consequences of a missed treatment or complications and possible treatment alternatives. Those results didn’t conform to the standard regulations of the Portuguese health guidelines regarding SIC.
Conclusion
Even though improvements in SIC were attained in recent years, our study suggests that the implementation of SIC is still suboptimal in surgical practice. It is important to raise awareness for the obtention of SIC by the healthcare team, because complete information before an invasive procedure is an ethical requirement.

Exploring the Adequacy of Obtaining Informed Consent for Caesarean Deliveries – A Patient Perspective
Theletsane, T. Cronje, B.G Lindeque, S. Adam
Obstetrics and Gynaecology Forum, 30 November 2021; 31(2)
Abstract
Obstetrics
The objective of this study was to assess the adequacy of informed consent obtained from patients prior to caesarean delivery.
Design
Descriptive study
Setting
Tertiary level hospitals in a major South African center in Pretoria, South Africa Subjects: Two-hundred-and-fifty patients who underwent elective and emergency caesarean deliveries
Outcome Measures
The assessment of the adequacy of the informed consent was assessed via a questionnaire that the participants answered on day 2-3 post caesarean delivery.
Results
Average age of participants was 28.8 years (28.75 ± 5.92). Twenty three percent (23.2%) of the participants underwent elective and 76.8% underwent emergency caesarean deliveries. Seventy five percent (75.6%) of the participants knew the name of the procedure, although only 29.2% were aware of the associated risks, and 59.2% of participants knew of their right to refuse the procedure.
Conclusion
Adequate communication is essential to all aspects of medicine and this study has highlighted the inadequacy of the informed consent process that takes place at our institution. Information regarding risks and complications was not adequately communicated. A standardized informed consent document that healthcare professionals can use for counseling, starting antenatally, should be considered.

Is informed consent practice in a general surgery unit adequate? An audit report
Original Article
Sameeah Hanif, Muhammad Nawaz, Sumera Naseem
Pakistan Journal of Medical Sciences, 29 June 2021; 37(3) pp 192-195
Open Access
Abstract
Objective
To obtain an informed consent is essential part of surgical practice. It not only ensures patients rights but also decreases the chances of legal proceedings against surgeons in case of any issue from procedure. The objective of this study is to evaluate the prevailing practices of getting informed consent and documentation in case of general surgical patients.
Material and Methods
This cross sectional (audit) study was carried out in department of Surgery District Head Quarter (DHQ), Abbottabad from December 2020 till February 2021 in general surgical unit. 132- patients chosen randomly were included. Both cases of elective as well as emergency cases were included. Patient operated on General and spinal anesthesia were interviewed according to questionnaire relating to informed surgical practices. Data of interviewed patients were analysed using spss 17.
Results
132 patients were included in study. Mean age was 34.98±16.1 years. Study comprised of 70 female(53%) and 62(47%) male. 117(88.6%) consent were taken by house officers while 15(11.4%) consent were taken by operating surgeon. 84(63.6%) consent were signed by patients themselves while 48(36.4%) were signed by relatives. All 132(100%) consent were written consent.
Conclusion
The quality of obtaining consent is below optimal and needs improvement. Education amongst health care workers is required so that they realize the importance of patients right’s so they make their own independent decision in the light of knowledge given. Also knowing that to have a complete and up to mark consent is beneficial for clinician in case of legal issues.

The Microethics of Informed Consent for Early Feminizing Surgery in Congenital Adrenal Hyperplasia
Katharine B. Dalke, Arlene B. Baratz
Journal of Pediatric Ethics, Spring 2021
Open Access
Abstract
Early surgery for genital difference in 46,XX congenital adrenal hyperplasia (CAH) is highly controversial, with contested evidence of benefits and risks. While professional urological societies and a parent-led CAH advocacy group maintain that families should have the option to consent for surgery for their child, former patients, intersex-led advocacy groups, and human rights and medical organizations denounce surgery on unconsenting infants for non-life-threatening genital variations. In the absence of clear data, clinicians are encouraged to engage in shared decision making with parents to obtain their fully informed consent. Unexplored microethics issues regarding clinicians’ implicit bias for treatments may interfere with their ability to obtain parents’ fully informed consent in this setting. Implicit bias may be inferred from parents’ experiences and from official and unofficial communications from clinicians.