275 Informed Consent for surgery: Have we learned from Montgomery v. Lanarkshire 2015

Abstract

Abstract Introduction Informed consent is the process in which a healthcare provider educates a patient about the risk, benefits, and alternatives of an intended procedure. However, the consequence could be detrimental if all risks were not explained appropriately to the patient. Aim To investigate if all relevant risks were patient-consented before elective and urgent cholecystectomy and appendicectomy. Method A prospective audit was conducted at a District General Hospital for 2 weeks in September 2022 by checking the consent forms of the respective procedure. Peer-reviewed leaflet produced by EIDO Healthcare was used as the standard. Intervention was done by preparing a checklist of procedural risks to be used by the consenter. The data was collected for 2 weeks in October 2022 and analysed using Microsoft Excel. Results For cholecystectomy (n=15), 12 were done electively and 3 were urgent. Out of the 17 common cholecystectomy risks, 9 were discussed in all consents post-intervention compared to 3 before. 6 of the risks were discussed in ³30% more consents post-intervention. Explanation of post-cholecystectomy syndrome achieved the best improvement of being discussed in 53.3% more consent. For appendicectomy (n=9), out of the common 14 risks, only 2 risks were discussed in 30% more consents post-intervention. Conclusions The likely explanation for the sub-optimal improvement in the appendicectomy consent process was due to urgency. The nature of the procedure might have triggered a speeding up of the consent process which consequently exposed to unintentional omission. This emphasises the importance to address difficulties with the consent process to promote patient autonomy and prevent harm.