Consent to cataract surgery performed by residents

Area of Science:

• Ophthalmology
• Surgical Education
• Medical Ethics

Background:

• Surgical training, particularly resident involvement in patient procedures, presents ethical challenges concerning patient consent and surgeon-physician contracts.
• Disclosure of resident participation in cataract surgery is a key ethical consideration.
• The study addresses the potential conflict between the need for surgical training and patient autonomy.

Purpose of the Study:

• To determine the prevalence of consistent disclosure to patients regarding resident involvement in cataract surgery.
• To investigate the impact of such disclosure on patients' willingness to undergo the procedure.

Main Methods:

• A survey was distributed to 20 ophthalmologists at university-affiliated hospitals to assess their disclosure practices.
• Physicians recorded patient consent rates when residents performed part or all of the surgery.
• Response rate was low (25%), with non-respondents citing concerns about patient anxiety and potential patient loss.

Main Results:

• Only 5 out of 20 ophthalmologists completed the survey.
• Four of the five respondents reported not consistently disclosing resident involvement in surgery.
• Of 49 patients informed about trainee involvement, only 8 (16%) consented to the procedure.

Conclusions:

• Consistent patient disclosure regarding resident involvement in surgery is essential to mitigate litigation risks.
• Disclosure may adversely affect surgical education by potentially decreasing the number of cases available for resident training.
• Balancing informed consent with the needs of surgical education requires careful consideration.