Practice and factors affecting informed consent among healthcare workers for major surgical procedures at Gurage zone hospitals, South Ethiopia, 2022: a facility-based cross-sectional study
Bitew Tefera Zewudie, Shegaw Geze Tenaw, Yibeltal Mesfin, Haimanot Abebe, Zebene Mekonnen, Shegaw Tesfa Mengist, Bogale Chekole, Agere Aynalem, Tadele Lankrew, Yihenew Sewale, Muche Argaw, Tadesse Sahle, Daniel Tsega
BMJ Open, 20 January 2025
Open Access
Abstract
Objective
This study aimed to assess the informed consent practice process and associated factors among healthcare workers for major surgical procedures at Gurage zone hospitals, in 2022.
Methods and materials
Institution-based cross-sectional study was employed.
Settings
This study was conducted in Gurage zone hospitals.
Participants
All healthcare workers who have been working in Gurage zone hospitals of surgical, operation rooms and obstetrics/gynaecology wards had exposure to patients who had undergone surgery during the study period
Outcome
The primary outcome of the study was the practice of informed consent practice among healthcare workers in Gurage zone hospitals.
Result
A total of 448 study participants were involved in this study giving a response rate of 98%. The mean (±SD) age of the study participants was 29.16 (±4.06) years. The mean score of study participants towards the surgical informed consent was 19.5, and 260 (58%, 95% CI: 53.7, 62.5) of them had good practice in the surgical informed consent. In multivariable logistic analysis model, factors like favourable attitude towards informed consent 2.4 (1.556, 3.596), work experience participants 4.9 (2.8, 8.7), adequate knowledge of informed consent 2.5 (1.6, 3.9) and communication challenge 1.6 (1.07, 2.50) were independently associated with the practice of informed consent at a p value of <0.05.
Conclusion
More than half of healthcare providers had good practice towards the surgical informed consent process. The practice of informed consent is low, and it is better to work on healthcare providers’ in-service training, knowledge and attitude towards informed consent.

Evaluation of the readability of informed consent forms commonly used in dermatology and cosmetology in Türkiye
Mine Mujde Kus
Medicine Science, 12 January 2025
Abstract
Informed consent forms (ICFs) must contain all the necessary information related to medical interventions and be comprehensible to the patient. This study aims to determine the readability levels of the ICFs listed on the official website of the Turkish Dermatology Association. A total of 23 consent forms, accessible on the website (https://turkdermatoloji.org.tr/icerik/detay/289) of the Turkish Dermatology Association, were incorporated into the study and classified into seven distinct categories. Twenty-three consent forms available on the Turkish Dermatology Association’s website were included in the study and categorized into seven groups. The texts of these forms were loaded into readability software. To ascertain the readability levels of the included texts, the mean number of words per sentence, the mean word count, the mean number of words with four syllables or more, and the mean number of syllables were calculated using the Bezirci-Yılmaz and Ateşman formulas. These data were then statistically compared. The mean readability of all ICFs was at the high school level according to the Bezirci-Yılmaz formula and at a medium difficulty level according to the Ateşman formula. According to the Bezirci-Yılmaz formula, the Methotrexate ICF was at an academic level, while the ICFs for Cosmetic Procedures with Energy-Based Devices and Superficial Skin Renewal Methods were at the undergraduate level. When comparing the readability values of Bezirci-Yılmaz and Ateşman, a significant difference was found between five groups with multiple consent forms (p=0.006 for both). Pairwise comparisons revealed that the low readability of the ICFs for Cosmetic Procedures with Energy-Based Devices was responsible for this significant difference. The readability of these forms was at the undergraduate level, according to Bezirci-Yılmaz, and at a challenging level, according to Ateşman. The readability levels of the ICFs available on the official website of the Turkish Dermatology Association are low. These consent forms should be revised to guarantee that patients are sufficiently informed about the medical procedures they will undergo. Otherwise, patients and physicians may face legal challenges due to potential complications.

Developing an ethical framework for informed consent using human fetal and embryological collections: An Australian perspective
Research Report
Joyce El-Haddad, Nalini Pather
Anatomical Sciences Education, 8 January 2025
Abstract
The term “human fetal and embryological collections” refers to repositories or archives that house remains of human fetuses and embryos. Most of these remains have been obtained without informed consent from the next of kin, thus reflecting a time in history where this may have been acceptable. Previous quantitative studies seeking stakeholder perceptions toward these collections suggest that there is misalignment with the values of society today, and the current guiding frameworks pertaining to these collections. The aim of this study was to qualitatively explore and analyze the perceptions of key stakeholders regarding human fetal and embryological collections. Twenty-seven individuals signed up and completed the demographic survey. However, 25 attended the focus group interviews. The study sought to provide an in-depth exploration of how stakeholders perceive the value of fetal and embryological collections, and the importance of informed consent. The mean age of participants was 29.1 years of age with a gender distribution of 40.7% (n = 11 out of 27) men and 50.3% (n = 16 out of 27) of women. Thematic analysis identified four themes: (1) consent; (2) preparation for clinical practice; (3) equity and fairness; and (4) educational value, with several subthemes identified at macro, meso, and micro ethical levels. Macro subthemes included importance of informed consent, equity and fairness, and genetic composition. Meso subthemes included respect and privacy, and legal and institutional considerations. Micro subthemes included emotional considerations, preparation for clinical practice, and educational value. The results of this study indicate that ethical issues surrounding human fetal and embryological collections need careful consideration based on macro, meso, and micro ethical frameworks.

Documentation of informed consent for anaesthesia: A single-site retrospective audit at a rural Australian hospital
Research Article
Yannick J De Silva, Luke Anderson
Anaesthesia and Intensive Care, 6 January 2025
Excerpt
   Respecting patient autonomy and providing relevant information are the foundations of informed consent, especially in anaesthesia due to the complexity of procedures, the impact on consciousness and autonomic function, and the specific risks and complications associated with delivering anaesthesia. It is important to note that a statement indicating the need for anaesthesia for an operation does not constitute informed consent for anaesthesia. The Australian and New Zealand College of Anaesthetists (ANZCA) recommends recording significant details of the discussion in the patient’s notes, including the material risks and the agreement of the patient to undergo the anaesthesia. This aligns with the recommendation from the Royal College of Anaesthetists (RCoA), based in the United Kingdom (UK), which suggests documenting the risks, benefits, alternatives and concerns raised by the patient.

We conducted a retrospective clinical audit on the anaesthetic records of patients undergoing emergency and elective procedures over a 3-week period at a rural hospital in Australia, starting from 1 January 2024. Data were collected with reference to the recommendations by ANZCA and RCoA for documenting informed consent for anaesthesia. Since informed consent for anaesthesia is not included in the procedure consent form at our hospital, our audit focused solely on anaesthetic records. Ethical approval was not deemed required as per our local health district’s checklist for ‘Ethical Considerations in Quality Improvement, Service Evaluation and Audit Activities’…

The quality of informed consent from nurses’ and hospitalized patients’ points of view in Iran: A cross-sectional study
Naser Mozaffari, Mohammad Ali Mohammadi, Behrouz Jafari, Sirous Jafari
Journal of Nursing Reports in Clinical Practice, 6 January 2025
Open Access
Abstract
Informed consent constitutes a fundamental aspect of patient rights. How informed consent is procured significantly influences patient satisfaction during the treatment and care continuum and contributes to decreased mortality associated with high-risk medical interventions. The primary objective of this study is to assess the quality of informed consent from the perspectives of both nurses and hospitalized patients within the educational medical centers of Ardabil, Iran. This research employs a cross-sectional design involving a sample of 420 individuals drawn from the target population, comprising 210 patients and 210 nurses. Stratified random sampling was utilized for participant selection, with data collection occurring between February and July 2024. The instrument for data gathering consisted of a two-part questionnaire; the first section captured demographic information of both patients and nurses, while the second section focused on evaluating the quality of informed consent as perceived by nurses and patients. Data analysis was performed using inferential statistical methods, including independent t-test, one-sample t-test, the Chi-square test, and analysis of variance (ANOVA) test. The mean informed consent quality score was higher in nurses compared to patients (107.44 [standard deviation [SD]=14.85] vs. 103.84 [SD=17.53], P<0.05). Results of the one-sample t-test indicated that the quality of obtained informed consent from patients and nurses’ viewpoints was lower than the expected amount in information provision, understanding the information, voluntary participation, signing the consent form, and the interaction between the patient and the doctor. At the same time, the score assigned to decision-making competence was higher than the expected amount. The general quality of obtaining informed consent was unfavorable from nurses’ and patients’ points of view. It is recommended that the process of obtaining informed consent be modified and that transparency and capacity in all the stages of obtaining informed consent be improved.

Position of Informed Consent in Emergency Handling of Patients in Hospital
Hadi Zulkarnain, Zainal Arifin Hoesein
Journal Indonesia Law and Policy Review (JILPR), October 2024
Abstract
The Indonesian Constitution mandates that health must be the main thing in continuous sustainable development. Therefore, in order to create a good health law system, doctors must respect whatever the patient’s choice is, because if informed consent has occurred, then the rights and obligations between the doctor and the patient arise. However, the position of informed consent becomes unclear when there is emergency treatment of patients in hospitals. The problem studied is how is the position of informed consent in emergency treatment of patients in hospitals in law in Indonesia and the United States? The research method used is normative. The results of the study show that the position of informed consent in emergency treatment of patients in hospitals in law in Indonesia and the United States is different. In the health law system in Indonesia, the position of informed consent in emergency treatment of patients in hospitals is considered given, so that doctors who perform medical actions in order to save lives or prevent disability of a person in an Emergency and/or disaster are exempt from claims for compensation. A different thing happens in the health legal system in the United States, where the position of informed consent in emergency patient care in hospitals remains very important in law, because the legal consequences if informed consent is not given, are that the medical action is considered an act of abuse (intentionally) against the patient which causes the doctor and hospital to become parties who can be held legally responsible if the patient feels disadvantaged.