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Nurses' Legal Responsibilities I01:27

Nurses' Legal Responsibilities I

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Role of cognitive function in assessing informed consent for endoscopy.

A D Yeoman1, M J Dew, L Das

  • 1Gastroenterology Unit, Department of Medicine, Prince Philip Hospital, Llanelli, Wales.

Postgraduate Medical Journal
|January 7, 2006
PubMed
Summary

Patient understanding of informed consent is often poor, with cognitive impairment precluding comprehension but not guaranteeing it. Other factors significantly impact patient understanding of the consent process.

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Area of Science:

  • Medical Ethics
  • Cognitive Science
  • Patient Education

Background:

  • Patient comprehension of the informed consent process is frequently suboptimal.
  • The specific reasons for this lack of understanding remain poorly elucidated.
  • The influence of cognitive function on assessing patient understanding of consent has not been previously evaluated.

Purpose of the Study:

  • To evaluate the level of patient understanding of the informed consent process.
  • To determine the role of cognitive function in patients exhibiting low levels of understanding.

Main Methods:

  • Prospective study involving patient interviews post-consent and pre-procedure.
  • Assessment of understanding regarding procedure rationale, risks, details, and post-procedure care.
  • Administration of the Mini-Mental State Examination (MMSE) to assess cognitive function.

Main Results:

  • 36% of 100 interviewed patients demonstrated a low level of understanding.
  • All patients with a Mini-Mental State Examination (MMSE) score below 24 had low understanding.
  • While cognitive impairment precluded understanding, adequate cognitive function did not ensure it; men showed poorer understanding than women.

Conclusions:

  • Patient understanding of the informed consent process is suboptimal.
  • Adequate cognitive function does not predict high understanding, but cognitive impairment is a barrier.
  • Factors beyond cognitive dysfunction significantly influence low levels of understanding in the consent process.