Informed consent: optimism versus reality.

Abstract

To determine whether parents of children attending the outpatient general anaesthesia (OPGA) session at the Eastman Dental Hospital, London fully understand the proposed treatment. Observational study supported by structured questionnaires and interviews. Casualty service in the Department of Paediatric Dentistry and the Victor Goldman Unit (a day-stay general anaesthetic unit) of the Eastman Dental Hospital. The parents' understanding of the consent was assessed based on their knowledge of the actual treatment procedure, the type of anaesthesia to be used and the number and type of teeth that would be extracted. Fifty-two of the 70 subjects (74%) approached completed both parts of the survey (interviews one and two). Results showed that 40% of the written consent obtained from the parents were not valid. The subjects' knowledge of the proposed treatment improved on the day of the actual treatment although 19% of them still did not fully understand the procedure. There was a statistically significant increase in the proportion of valid consent on the day of the actual treatment. Many of the subjects had no knowledge of the type of anaesthesia that would be used for their children but were more aware of the number and type of teeth that were going to be extracted. The time interval between the consent process and the actual treatment did not have any significant effect on the subjects' understanding of the consent, but it implied that with time the subjects' knowledge improved. A proportion of subjects did not fully understand the proposed treatment procedure even after being adequately informed. Appropriate measures should be taken to ensure that the patients or their guardians truly understand the proposed treatment.