Informed consent practice for obstetric and gynaecologic procedures: A patients' perspective from a developing...

Area of Science:

• Medical Ethics
• Patient Safety
• Health Services Research

Background:

• Informed consent is a cornerstone of ethical medical practice.
• Understanding surgical informed consent (SIC) practices is crucial for patient autonomy and safety.
• Previous research has highlighted variations in SIC administration globally.

Purpose of the Study:

• To assess surgical informed consent (SIC) practices for obstetric and gynaecological (OB-GYN) procedures.
• To evaluate patient recall and understanding of SIC in Pakistani hospitals.
• To identify factors influencing the effectiveness of SIC in OB-GYN care.

Main Methods:

• A cross-sectional study was conducted in five hospitals (three public, two private) in Peshawar, Pakistan.
• A pretested, structured, tablet-based questionnaire was administered to post-operative OB-GYN patients.
• Data collection occurred between October 2016 and January 2017.

Main Results:

• Approximately 27% of patients did not recall formal consent administration, with higher rates in private hospitals.
• A significant majority (80%) felt they had no choice in signing consent forms.
• Patient recall of consent elements was positively associated with feeling empowered, having opportunities to ask questions, desiring more explanation, and receiving consent in their mother tongue.

Conclusions:

• Surgical informed consent practices for OB-GYN procedures in the studied Pakistani hospitals were suboptimal.
• Patients' experiences indicate a focus on obtaining legally valid signatures rather than ensuring genuine informed decision-making.
• Improving SIC requires addressing communication barriers, patient empowerment, and language concordance.