Abstract
BackgroundInformed consent in medical practice is essential and a global standard that should be sought at all the times doctors interact with patients. Its intensity would vary depending on the invasiveness and risks associated with the anticipated treatment. To our knowledge there has not been any systematic review of consent practices to document best practices and identify areas that need improvement in our setting. The objective of the study was to evaluate the informed consent practices of surgeons at University teaching Hospitals in a low resource setting.MethodsA cross-sectional study conducted at three university teaching hospitals in Uganda. Self-guided questionnaires were left at a central location in each of the surgical departments after verbally communicating to the surgeons of the intention of the study. Filled questionnaires were returned at the same location by the respondents for collection by the research team. In addition, 20 in-depth interviews were held with surgeons and a review of 384 patients’ record files for informed consent documentation was done.ResultsA total of 132 (62.1%) out of 214 questionnaires were completed and returned. Respondents were intern doctors, residents and specialists from General surgery, Orthopedic surgery, Ear, Nose and Throat, Ophthalmology, Dentistry, Obstetrics and Gynaecology departments. The average working experience of respondents was 4.8 years (SD 4.454, range 0–39 years). 48.8% of the respondents said they obtained consent all the time surgery is done while 51.2% did not obtain consent all the time. Many of the respondents indicated that informed consent was not obtained by the surgeon who operated the patient but was obtained either at admission or by nurses in the surgical units. The consent forms used in the hospitals were found to be inadequate and many times signed at admission before diagnosing the patient’s disease.ConclusionsInformed consent administration and documentation for surgical health care is still inadequate at University teaching hospitals in Uganda.
Highlights
Informed consent in medical practice is essential and a global standard that should be sought at all the times doctors interact with patients
To our knowledge there has not been any systematic review of informed consent practices for surgical care, and no documented best practices
About 29.3% of the respondents were intern doctors or residents in a surgical discipline, 16.5% were from general surgery, 16.5% from Obstetrics and Gynaecology, 9.8% from dentistry, 13.5% from orthopedics, 6% from ophthalmology, while 4.5% were general practitioners
Summary
Informed consent in medical practice is essential and a global standard that should be sought at all the times doctors interact with patients. Its intensity would vary depending on the invasiveness and risks associated with the anticipated treatment. To our knowledge there has not been any systematic review of consent practices to document best practices and identify areas that need improvement in our setting. The objective of the study was to evaluate the informed consent practices of surgeons at University teaching Hospitals in a low resource setting. It’s intensity varies depending on the invasiveness and risks associated with the anticipated treatment [11]. Surgery is an invasive practice and would require a more rigorous informed consent process for improved shared decision making because of the higher frequency and intensity of associated risks as compared to general medical care. This study was intended to evaluate what the surgeons at teaching hospitals do regarding informed consent because it impacts their trainees’ knowledge and practice
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