Evaluation of the surgical informed consent for elective and emergency surgeries in obstetrics and gynaecology in Saudi Arabia
Research
Maryam Al-Meshkhas, Zahraa Alakrawi, Sumaiah Alrawiai
BMC Medical Ethics, 12 March 2025
Open Access
Abstract
Background
Informed consent (IC) represents one of the fundamental rights of patients in healthcare. An essential aspect of the IC process is providing patients with equal access to information to enable them to make the right decisions. However, failure to obtain IC undermines patient autonomy, lowers patient satisfaction, increases risks, and negatively affects the patient’s trust in healthcare providers. This study aims to evaluate the surgical informed consent (SIC) process from the patient’s perspective both for emergency and elective surgeries in obstetrics/genecology in Saudi Arabia.
Methods
This is a quantitative cross-sectional study. The study population included all hospitalized female patients who had undergone obstetric or gynaecological surgeries, from February 2021 to March 2021. The total sample size was 156 female patients.
Results
Most of the participants were married (96.2%) and unemployed (80.1%). The most performed surgery was caesarean Sect. (84%). Most of the patients were satisfied with their SIC experience which represents over 85%. No significant difference has been found between the elective and emergency surgeries. However, person-in-charge of SIC administration and the time provided to sign the IC were deemed to be significant predictors.
Conclusion
Based on the findings, it is recommended that physician take responsibility for the SIC administration rather than an unknown provider. It is also recommended to provide the patients with adequate time to understand the SIC. Furthermore, ensuring the availability of emotional support is critical for enhancing the patient experience.

Barriers and willingness to express consent to organ donation among the Kazakhstani population
Research
Aidos Bolatov, Aruzhan Asanova, Gulnur Daniyarova, Vitaliy Sazonov, Yuliya Semenova, Aigerim Abdiorazova, Yuriy Pya
BMC Public Health, 3 March 2025
Open Access
Abstract
Background
Organ donation is a critical component of healthcare, yet donation rates in Kazakhstan remain low. Understanding the socio-demographic factors, knowledge levels, and perceived barriers influencing individuals’ willingness to consent to organ donation is essential for developing effective interventions.
Methods
This cross-sectional study surveyed 1,294 participants across Kazakhstan. The sample was predominantly female (78.3%), urban (79.4%), and well-educated, with a significant proportion having medical backgrounds. Data were collected on socio-demographic characteristics, knowledge about organ donation, and perceived barriers. Comparison methods and binomial logistic regression analysis was used to identify significant predictors of willingness to express consent for organ donation.
Results
Age, ethnicity, family status, and knowledge about organ donation were significant predictors of willingness to donate. Older participants and Russian ethnic group members were less likely to consent, while widowed individuals and those with higher knowledge levels were more likely to express consent. Although several factors did not have significant prediction with willingness to donate in the regression analysis, chi-square and U-tests revealed significant associations for residence, occupation, educational level, and religious affiliation. Key barriers to donation included distrust in the medical system, fears of organ trafficking, and insufficient awareness, particularly among non-medical participants. These barriers were significant deterrents and correlated with lower willingness to donate. However, due to the overrepresentation of urban, educated, and medical-affiliated participants in the sample, findings may not fully reflect the general population of Kazakhstan.
Conclusion
The findings highlight the need for targeted educational campaigns to increase public awareness and address misconceptions about organ donation. Building trust in the medical system and dispelling fears of unethical practices are essential for improving donation rates. The study underscores the complex interplay of socio-demographic factors, knowledge, and perceived barriers in shaping organ donation decisions in Kazakhstan, while also emphasizing the need for future research with a more representative sample.

Community engagement approaches and lessons learned: A case study of the PRECISE pregnancy cohort study in Kenya
Onesmus Wanje, Angela Koech, Maggie Woo Kinshella, Grace Mwashigadi, Alice Kombo, Grace Maitha, Nathan Barreh, Hiten D Mistry, Rachel Craik, Marianne Vidler, Marie-Laure Volvert, Peter von Dadelszen, Marleen Temmerman, The Precise Network
Fronteirs of Public Health, 24 February 2025
Abstract
Community engagement (CE) has been recommended as an important ethical consideration for health research to enhance informed consent and exchange knowledge between researchers and community members. The purpose of this paper is to describe how CE was developed and delivered for the PRECISE prospective pregnancy cohort study in Kenya. PRECISE enrolled pregnant women in antenatal care, followed them up to the postpartum period, and collected data and biological samples to enable the study of placental disorders in sub-Saharan Africa. Initially CE was aimed at informing the community about the study, establishing community-wide acceptance of the research and addressing concerns about biological sample collection to facilitate participation in the study. CE later evolved to be a platform for mutual learning aiming to deepen the community’s understanding of research principles and informed consent and providing a feedback loop to researchers. We engaged diverse stakeholders including health workers and managers, local administrators, religious and traditional leaders, older women, pregnant women, non-pregnant women and men. We utilized a variety of CE approaches and tools adapting to the specific contextual factors at the study sites. Achievements included widespread understanding of informed consent and research principles, clarification of misconceptions, and dispelling of fears regarding biological sample collection. The relationship with the community was strengthened evidenced by frequent inquiries and active participation in CE activities and the research study. For effective CE, we recommend involvement of community members in the CE team and continuous and adaptive CE throughout the study period.

Informed Consent for Breast Cancer: The Perspective of Physicians in Japan
Review
Erika Suzuki, Hiroyuki Takei
Journal of Nippon Medical School, 2025
Abstract
Informed consent (IC) is closely related to shared decision making (SDM), and SDM can lead to IC. IC is fundamental to medical ethics as described in the Geneva, Helsinki, and Lisbon declarations and is essential for clinical practice, as it provides legal protection for healthcare professionals. IC should be achieved through SDM based on both narrative-based medicine and evidence-based medicine. SDM should also involve healthcare professionals other than physicians (e.g., nurses, pharmacists, social workers). Communication skills for IC are important and are encapsulated in the SPIKES protocol. IC for breast cancer treatment requires explanation of the roles of local and systemic therapy. A documented “do not attempt resuscitation” order should be obtained for end-of-life IC.

Editor’s Note:
The referenced declarations in the abstract are further identified in this article excerpt:
…Medical Ethics and Informed Consent
Three declarations are relevant to medical ethics: the Declaration of Geneva on the physician’s pledge[6], the Declaration of Helsinki on ethical principles for medical research involving human subjects[7], and the Declaration of Lisbon on the rights of the patient[8]. These documents confirm that IC is essential to the provision of medical care. In particular, the content of the explanations given to patients in medical research must be based on the principles of the Declaration of Helsinki and approved by the ethical review committee of each institution[9].

6．World Medical Association. WMA Declaration of Geneva [Internet]. Ferney-Voltaire; World Medical Association: 2024. Available from: https://www.wma.net/policies-post/wma-declaration-of-geneva

7．World Medical Association. WMA Declaration of Helsinki- Ethical Principles for Medical Research Involving Human Participants [Internet]. Ferney-Voltaire; World Medical Association: 2024. Available from: https://www.wma.net/policies-post/wma-declaration-of-helsinki-ethical-principles-for-medical-research-involving-human-subjects

8．World Medical Association. WMA Declaration of Lisbon on the Rights of the Patient [Internet]. Ferney-Voltaire; World Medical Association: 2024. Available from: https://www.wma.net/policies-post/wma-declaration-of-lisbon-on-the-rights-of-the-patient