Research Article: Patients’ Perception of Quality of Pre-Operative Informed Consent in Athens, Greece: A Pilot Study

Date Published: November 26, 2009

Publisher: Public Library of Science

Author(s): Matthew E. Falagas, Patrick D. Akrivos, Vangelis G. Alexiou, Vasilios Saridakis, Theofanis Moutos, George Peppas, Barbara K. Kondilis, Michael Goodyear.

Abstract: We sought to perform a study to record and evaluate patients’ views of the way surgeons communicate informed consent (IC) in Greece.

Partial Text: Certain aspects of obtaining and giving informed consent (IC) became an issue in biomedical ethics for the first time during a period stretching from the mid-17th to the early 19th century; IC was concerned with the same principles that prevail today [1]. Nowadays, informed consent has replaced the old paternalistic notion of “the doctor knows best”, with a more collaborative patient-physician relationship. Patients expect to be informed of the risk of surgical interventions[2]. Communication is a key component especially in the case the patient has to weigh the risks and benefits of a recommended treatment, and the overall quality of patient care[3]. On the other hand, it seems that even though patients welcome the collaborative spirit, they may not all be interested in taking complete charge of their medical decisions[4], some prefer the physician to be the primary decision maker[5] and a few are even willing to surrender utter control to their physician[6], [7].

All patients approached agreed to complete the questionnaire. In total, 77 patients (42 males) operated by eight different surgeons, volunteered to respond to the questionnaire. Forty-three respondents (56%) were from 18 to 55 years old, only one was below 18, and the rest 33 (43%) were older than 55 years. Regarding the marital status, 22%, 57%, 10%, and 8% of the respondents were single, married, divorced and widowed, respectively. Nine percent (9%) of the respondents were of lower educational level (elementary school) while 91% of the respondents had at least secondary level education. Specifically, only 2.6% of the respondents did not graduate from the primary school, 40% were university graduates, 12% were technical school graduates. Ninety-six percent of participants were of Greek ethinicity, only three (4%) participants were non-Greeks.

One of the main findings of this exploratory pilot study is that information that should be delivered through the IC process did not reach patients in all cases (14.3% of the respondents achieved a delivered information index between 3 and 5 and 29.8% had a score between 6 and 8). Thus, the main goal, to get informed about the recommendation and reasoning process of the doctor, was not fully achieved. In most cases patients partially comprehended substantial information regarding the benefits, risks and inconveniences of the suggested treatment. This finding is in accordance with other investigators suggesting that, even though the health care provider has an ethical and legal responsibility to ensure comprehension of IC, it is unclear whether the means of communicating medical information to the patients are effective[15], [16].



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