Consent In Obstetrics Research Articles

The Current Practice and Medico Legal Aspects of Informed Consent in Obstetrics and Gynaecology in a Teritary Care Hospital, Can We Improve?: An Interventional Study

The Informed Consent plays major role in both Patients and the Doctors to carry out variousaspects in the surgical procedures. This paper was an interventional study it was conducted in the Department of Forensic Medicine and Toxicology, Sri Manakula Vinayaga Medical College and Hospital, Madagadipet, Puducherry to audit and to improve it was conducted in the Department of Obstetrics and Gynaecology. The deficiencies were identified and it was analysed. The results of both pre-interventional and post-interventional were recorded, which showed the significant improvement in the consent form of the major and minor procedures. This study results will give importance on documenting the Informed Consent day to day life practice.

Informed consent and birth preparedness/complication readiness: A qualitative study at two tertiary maternity units.

Informed consent in obstetrics should involve full disclosure of risks, benefits and alternative interventions. However, we have found no evidence of a formal informed consent process before an attempt at vaginal delivery in published policy or practice. The idea of informed consent in vaginal birth has attracted controversy and has been the subject of some debate. To explore the perspectives and experiences of informed consent and birth preparedness/complication readiness for birthing women in a high resource setting. Qualitative study using semi-structured interviews to examine experiences and perspectives of women following birth. Forty telephone interviews were concluded. Eight statement categories were identified: (i) no issues of consent, (ii) absent/inadequate informed consent, (iii) adequate birth preparedness/complication readiness, (iv) inadequate birth preparedness/complication readiness, (v) desire to forfeit decision making to a trusted and accountable health professional, (vi) belief that informed consent is not realistic in birth under some circumstances, (vii) negative feelings related to birth and (viii) poor postnatal follow-up. When complications arose during birth, 20% of participants felt that informed consent was absent/inadequate, 25% of participants suggested policy change in favour of a formal informed consent process and 55% of participants suggested policy change in favour of increased birth preparedness/complication readiness. Our study suggests that informed consent for vaginal birth and formal birth preparedness/complication readiness should form part of routine antenatal care. Women's preferences for decision-making and informed consent should be established before birth.

Practices of Documentating the Pre-Operative Informed Consent in Obstetrics and Gynaecology in a Tertiary Care Hospital – An Interventional Study

An informed consent form plays a major role both in giving the needed information for the patient andas a legal tool for the doctor to carry out various diagnostic and therapeutic procedures. This paper wasan interventional study, conducted in Department of Forensic Medicine, Sri Manakula Vinayagar MedicalCollege and Hospital, Madagadipet, Puducherry to audit and improve the current practices of using informedconsent forms by the faculties of Department of Obstetrics and Gynecology. The practice of documentingthe informed consent forms obtained during the major surgeries of the concerned department was analyzedusing a validated check-list. Deficiencies were identified in the documentation and an intervention wascarried out to stress on the importance of documentation in the consent forms and the post-interventionalconsent forms were analyzed against the same validated check-list. The results of both the pre- and postintervention data on the documentation of consent form were analyzed and compared, which showed asignificant improvement in the documentation of the informed consent forms by the faculties of the Obstetricsand Gynecology Department. This study result will emphasis the role of intervention mode used to enhancethe documentation of informed consent forms.

Informed consent in obstetrics – a survey of pregnant women to set a new standard for consent in emergency obstetric interventions

Informed consent is necessary for all medical, surgical and obstetric interventions. Whilst informed consent can be obtained for elective procedures, it is much more challenging to obtain for emergency interventions. It can be difficult for women to understand the need for emergency intervention when pregnancy has been low risk. This can lead to problems with psychological trauma from the delivery being foremost in their minds in the postnatal period and in future pregnancies. The Montgomery ruling of 2015 encouraged informing women about risks and benefits of interventions and letting the women take responsibility for their own decision-making. Here, a patient-focused survey collected information on pregnant women’s knowledge and wishes regarding emergency interventions. The responses were analysed in relation to local and Scottish national delivery data. We have initiated a novel programme to ensure all of our pregnant women are empowered to give informed consent for emergency interventions. IMPACT STATEMENT What is already known on this subject? There has been very little published on this subject to date and what has been published has involved focus groups or very small numbers of women. What do the results of this study add? This study adds significantly to our understanding of current Scottish and Highland regional delivery statistics to help foster realistic delivery expectations in our pregnant women. This study is the first to report on pregnant women’s understanding of the possibility of requiring emergency intervention in labour and the relevant risks. It also highlights the fact that women prefer to get their information from community midwives, friends and family rather than their obstetricians or GPs. This study is also the first to report women’s actual preferences and comments with regard to information provision, labour and delivery experiences and their wishes for the future. What are the implications of these findings for clinical practice and/or further research? The findings from this study have allowed us to develop and implement a novel means of obtaining informed consent in emergency obstetrics and the success of this programme will be reported following future analysis of patient experiences.

Informed Consent in Obstetrics and Gynecology: Indian Scenario

AbstractInformed consent is the process by which the treating health care provider discloses appropriate information to a competent patient so that the patient may make a voluntary choice to accept or refuse treatment. Or, in simple words, consent is agreement or permission to do or allow something. The element of consent is one of the critical issues in the area of medical treatment today. It is well known that the patient must give valid consent to medical treatment; and it is his or her prerogative to refuse treatment even if the said treatment will save their life. No doubt this raises many ethical debates and falls at the heart of medical law today. This study reviews the various provisions by the Royal College of Obstetricians and Gynaecologists for consent in obstetrics and gynecology as well as the Indian legal provisions in consent.

Implementation of Informed Consent in Obstetrics and Gynecology Operations in Khartoum- Sudan 2009

Objectives: - This is a descriptive, cross-sectional study, done in Khartoum state to assess patients and providers’ knowledge and practice on informed consent in obstetrics and gynecology operations during year 2009.Methodology:- After an informed consent from patients and hospital directorate, data was collected by interview of both patients and health care providers at department of obstetrics and gynecology in all Khartoum state hospitals, during the period from first of January to 31st of December 2009.Results: - In this study, 544 patients and 393 health care providers were included. Informed consent is known to be important to 355 (90.3%) of health care providers, its contents are wholly or partially known to 263 (66.9%). It was taken for surgical operation by 298 (75.8%) of providers, it was written in 279/ 298 (93.6%) and verbal in 19 /298 (06.4%). Written consent was signed by the husband, the patient herself or her relatives. Lack of time and language are the main reasons for, not taking an informed consent.Conclusion: - Although informed consent is relatively implemented; its requirements were not properly fulfilled. Not taking an informed consent is influenced by multifactorial barriers including lack of time, language and lack of experience. Pre and in-service training on informed consent and communication skills, with detailed format of informed consent will improve the situation.Keywords: labour, medical ethics, legal litigations.

Consent in obstetrics and gynaecology

Valid consent is an integral part of the practice of obstetrics and gynaecology. There are many special problems in this area, especially as the women involved may be ill or may be healthy and requesting lifestyle procedures such as sterilization. In obstetrics, difficult decisions may involve the unborn baby. Allegations of failure to obtain valid consent frequently form the basis of complaints and litigation.

産婦人科におけるインフォームド・コンセント ─患者へのアンケート調査結果から─

産婦人科におけるインフォームド・コンセント ─患者へのアンケート調査結果から─

Consent in obstetrics ‐ a legal view

Consent in obstetrics ‐ a legal view

Consent in obstetrics ‐ a legal view

Consent in obstetrics ‐ a legal view

Consent in obstetrics – a legal view

Consent in obstetrics – a legal view

Consent in obstetrics – a legal view

Consent in obstetrics – a legal view

Consent in obstetrics – a legal view

Consent in obstetrics – a legal view

Consent in Obstetrics

Consent in Obstetrics

“Ethical dimensions of informed consent”: A psychiatric perspective

I n Ethical Dimensions of Informed Consent, the ACOG Committee on Ethics addresses the tensions between the extremes of traditional paternalistic coercion and modern psychological abandonment, between the lures of oversimplification and the paralyzing dangers of complexity. Questions of consent in obstetrics and gynecology are made especially poignant by the psychologically loaded implications of the procedures consented to or refused, and their closeness to powerful, universal, and mysterious human drives and values. Consent is also complicated by the inadequacy of information about the outcome of many of the interventions proposed. Nevertheless, as the Committee on Ethics explains so well, informed consent represents a legal, ethical, and clinical imperative. This commentary by a psychiatrist will deal with some of the psychosocial realities impinging on informed consent, and offer clinical suggestions. Under the guise of informed consent, emotional processes and decisions may masquerade as or be reduced to cognitive ones. Consulting psychiatrists frequently discover that a clear, but unexplored, psychological dilemma is at the root of what seems to be an ethical impasse. For example, the patient who is refusing a lifesaving procedure on grounds of autonomy is not aware of, or cannot acknowledge, an overwhelming terror arising from an unresolved past experience. The clinicians cannot grasp the psychological meaning of a religious proscription against a particular intervention (blood transfusion). Resolution of the psychological conflict solves the ethical conflict. Questions of informed consent in obstetrics and gynecology involve medical/surgical interventions performed on the reproductive organs of women. Discussion of informed consent in this context must take into account women's psychology, as it pertains both to their reproductive organs and capacities and to their management of medical information, women's traditional and evolving role in society, and the history of women's treatment in the medical setting. Women's reproductive organs tend to be experienced by them and by medical professionals as messy, dirty, troublesome--with the trouble ranging from inconvenient (menstruation) to life-threatening (ovarian malignancies). There has been a corresponding tendency in Western medicine to look © 1993 by The Jacobs Institute of Women's Health 1049-3867/93/$6.00

Two patients or one? Problems of consent in obstetrics.

As technology provides us with more and more information, the status of the unborn child becomes increasingly inflated. This makes it easy to lose sight of the mother as an individual whose wishes are to be respected. She is viewed as a foetal container. Her wishes are respected on condition that they do not endanger the life of the child she is carrying. Even the courts now treat the pregnant woman differently to her non-pregnant fellows, as illustrated in Re S (an English case) and the case of AC (an American case). The laws regarding the foetus in England and Wales and in America are explored. The conclusion reached is that there is no law requiring heroic acts, and that the common law protects the individual from assault and battery. While the child is within the mother her actions would necessarily have to be curtailed in order to protect the interests of the foetus. While within the womb the foetus is a subset of the mother, inextricably linked to her. We cannot hope to protect it by laws that punish the mother, we can only strive to protect the interests of the foetus by protecting the interests of the mother. Once born, however, we can protect the child with the full force of the law from any abuse, neglect or wrongful treatment which it may incur.