Quality of informed consent for invasive procedures

Area of Science:

• Medical Ethics
• Patient Safety
• Healthcare Quality Improvement

Background:

• Informed consent is a cornerstone of ethical medical practice.
• Assessing the quality of informed consent and understanding patient decision-making preferences are critical for patient-centered care.

Purpose of the Study:

• To evaluate the quality of informed consent provided to patients before medical procedures.
• To explore patients' preferences regarding decision-making roles in their healthcare.

Main Methods:

• A cross-sectional survey was conducted with hospitalized and ambulatory patients.
• Data collected included recall of explanations, decision-making preferences (shared, autonomous, paternalistic), and satisfaction levels.
• An intervention to improve recall by asking patients to restate explanations was implemented and assessed.

Main Results:

• A significant proportion of patients (50% for risks, 67% for alternatives) did not recall key information.
• The intervention to improve recall was largely ineffective (<10% compliance).
• Patient preferences varied, with 60% favoring shared decision-making, 20% autonomous, and the rest paternalistic; 80% reported high satisfaction.

Conclusions:

• Current informed consent processes often fail to ensure patient recall of essential information.
• Physician adherence to improving informed consent practices remains a challenge.
• Developing better tools to measure consent quality and adopting patient-specific approaches to decision-making are recommended.