Do surgeons and patients discuss what they document on consent forms?

Area of Science:

• Medical ethics
• Surgical practice
• Patient communication

Background:

• Previous studies indicate surgeons often fall short of informed consent standards.
• The Veterans Affairs (VA) Healthcare System implemented standardized, procedure-specific consent forms.
• This study investigates if VA's standardized forms improve informed consent practices.

Purpose of the Study:

• To compare the content of surgeon-patient discussions with standardized VA consent forms.
• To assess the quality of informed consent in the context of new VA procedures.

Main Methods:

• Prospective cohort study of patients undergoing cholecystectomy or inguinal herniorrhaphy.
• Audio recordings of surgical provider-patient encounters.
• Comparison of discussed information against standardized consent form content.

Main Results:

• Discussions covered 33-37% of standardized form information for herniorrhaphy and cholecystectomy.
• Patient-provider discussions frequently included details not on standardized forms.
• Most discussions (76-80%) included key elements like risks, benefits, and procedure details.

Conclusions:

• Observed informed consent process was detailed, challenging prior reports of inadequate practice.
• Discrepancies between discussed and documented information pose legal/ethical risks.
• Opportunities exist to enhance the iMed system to better capture discussions and patient needs.