Examining the variation in consent in general surgery
Research Article
A Sebastian, L Wyld, JL Morgan
The Annals of The Royal College of Surgeons of England, 23 May 2023
Abstract
Introduction
Consent is a fundamental aspect of surgery and expectations around the consent process have changed following the Montgomery vs Lanarkshire Health Board (2015) court ruling. This study aimed to identify trends in litigation pertaining to consent, explore variation in how consent is practised among general surgeons and identify potential causes of this variation.
Methods
This mixed-methods study examined temporal variation in litigation rates relating to consent (between 2011 and 2020), using data obtained from National Health Service (NHS) Resolutions. Semi-structured clinician interviews were then conducted to gain qualitative data regarding how general surgeons take consent, their ideologies and their outlook on the recent legal changes. The quantitative component included a questionnaire survey aiming to explore these issues with a larger population to improve the generalisability of the findings.
Results
NHS Resolutions litigation data showed a significant increase in litigation pertaining to consent following the 2015 health board ruling. The interviews demonstrated considerable variation in how surgeons approach consent. This was corroborated by the survey, which illustrated considerable variation in how consent is documented when different surgeons are presented with the same case vignette.
Conclusion
A clear increase in litigation relating to consent was seen in the post-Montgomery era, which may be due to legal precedent being established and increased awareness of these issues. Findings from this study demonstrate variability in the information patients receive. In some cases, consent practices did not adequately meet current regulations and therefore are susceptible to potential litigation. This study identifies areas for improvement in the practice of consent.
Month: July 2023
To find out how knowledgeable patients at tertiary care institutions are about giving informed consent and receiving counseling
To find out how knowledgeable patients at tertiary care institutions are about giving informed consent and receiving counseling
Original Research
Mohammad Sufyan
Journal Of Cardiovascular Disease Research, 26 March 2023; 4(14)
Abstract
Aim
The purpose of this study is to find out how knowledgeable patients at tertiary care institutions are about giving informed consent and receiving counseling.
Material and Methods
Two groups made up the whole of the research: the first group consisted of fifty surgical trainees from general surgery, orthopaedics, obstetrics, and ENT, while the second group included fifty patients who had had a variety of surgical procedures. Both groups were exposed to the identical conditions over the same time period of the research. For the purpose of determining whether or not the counselling session addressed all of the essential components of providing informed consent for the surgical treatment, we have developed a systematic questionnaire.
Results
The final analysis took into account each of the 50 residents as well as the 50 patients. The risks and repercussions of the procedure were described in detail by 45 (or 90%) of the resident physicians as one of the most important aspects of the informed consent process. Natural history, the progression of the illness, and the prognosis were discussed by 19 resident physicians (38 percent), but alternative therapies and the name of the procedure were cited by 17 (34 percent) and 15 (30 percent), respectively. The patients themselves gave their permission in 37 (74%) of the instances, while their spouses gave their consent in 13 (26%) of the cases. Verbal permission was selected by 35 surgeons (70%) while written consent was selected by 15 surgeons (30%) as the technique of choice for getting agreement for minor operations and local anesthesia.
Conclusion
By adding patient counseling and intensifying patient selection, it is possible to increase both the overall happiness of patients and the results overall. A template for informed consent that includes all of the necessary information and leaves flexibility for customization needs to be established so that the process of obtaining informed consent may be completed more quickly.
Chapter 4 Capacity-Increasing Technologies and the Problems of Informed Consent
Chapter 4 Capacity-Increasing Technologies and the Problems of Informed Consent
Book Chapter
Military Ethics and the Changing Nature of Warfare, 2023 [Brill]
Jean-François Caron
Abstract
Obtaining informed consent from members of the armed forces prior to their use of capacity-increasing technologies or medicines is plagued by numerous hurdles. This chapter argues that there are reasons to rethink the relevance of this criterion in favor of rethinking how these technologies and medicines ought to be tested in their developmental phase.
Center for Informed Consent Integrity 