Abstract
BackgroundIt has been reported by some studies that the desire to be involved in decisions concerning one’s healthcare especially with regard to obtaining informed consent is related to educational status. The purpose of this study, therefore, is to assess the influence of educational status on attitude towards informed consent practice in three south-eastern Nigerian communities.MethodsResponses from consenting adult participants from three randomly selected communities in Enugu State, southeast Nigeria were obtained using self-/interviewer-administered questionnaire.ResultsThere were 2545 respondents (1508 males and 1037 females) with an age range of 18 to 65 years. More than 70% were aged 40 years and below and 28.4% were married. More than 70% of the respondents irrespective of educational status will not leave all decisions about their healthcare to the doctor. A lower proportion of those with no formal education (18.5%) will leave this entire decision-making process in the hands of the doctor compared to those with tertiary education (21.9%). On being informed of all that could go wrong with a procedure, 61.5% of those with no formal education would consider the doctor unsafe and incompetent while 64.2% of those with tertiary education would feel confident about the doctor. More than 85% of those with tertiary education would prefer consent to be obtained by the doctor who will carry out the procedure as against 33.8% of those with no formal education. Approximately 70% of those who had tertiary education indicated that informed consent was necessary for procedures on children, while the greater number of those with primary (64.4%) and no formal education (76.4%) indicated that informed consent was not necessary for procedures on children. Inability to understand the information was the most frequent specific response among those without formal education on why they would leave all the decisions to the doctor.ConclusionThe study showed that knowledge of the informed consent practice increased with level of educational attainment but most of the participants irrespective of educational status would want to be involved in decisions about their healthcare. This knowledge will be helpful to healthcare providers in obtaining informed consent.
Highlights
It has been reported by some studies that the desire to be involved in decisions concerning one’s healthcare especially with regard to obtaining informed consent is related to educational status
65 (18.5%) of those with no formal education and 83 (21.9%) of those with university/polytechnic education would leave the doctor to take all decisions about their health management (Table 2)
The proportion of those who would require the doctor to disclose everything about the procedure and be allowed to make a choice significantly decreased from 227 [64.7%] in those with no formal education to 213 [56.2%] in those with university/polytechnic education (P < 0.01)
Summary
It has been reported by some studies that the desire to be involved in decisions concerning one’s healthcare especially with regard to obtaining informed consent is related to educational status. The patient has the right to self determination, a mentally competent adult has the right to give or withhold consent to any diagnostic or therapeutic procedure and has the right to the information necessary to make his/her decisions. Such information should be given in a way appropriate to the patient’s culture and in such a way that the patient can understand. The doctrine of informed consent emphasizes the right to self-determination of a patient It requires a physician, before embarking on any diagnostic or therapeutic procedure which carries with it a reasonable possibility of harm to explain the attendant risks of the procedure and its alternatives and to obtain the competent, voluntary and understanding consent of the patient to proceed [2]. It has been suggested that the term “informed consent” should be changed to “informed request” for a procedure by the patient reflecting the active role the patient plays and to underscore the fact that the patient retains the right to decline consent [6]
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