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Related Concept Videos

Nurses' Legal Responsibilities I01:27

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In healthcare, informed consent is a crucial process that involves thoroughly communicating medical treatment options to patients, including benefits, risks, potential side effects, and alternatives. This process enables patients to make well-informed decisions about their care, ensuring they understand the implications of their choices before consenting to or refusing treatment.
The legal responsibilities of a nurse regarding informed consent include the following:
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The upper limb consists of the arm, forearm, wrist, and hand bones. The humerus is the single bone of the upper arm region. Proximally, it has a large, spherical, smooth head that articulates with the glenoid cavity of the scapula to form the glenohumeral or shoulder joint. The margin of the head is the anatomical neck, a residual epiphyseal plate. Laterally it extends to form bony projections called the greater tubercle and the lesser tubercle. Next to the tubercles is the surgical neck, a...
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The muscles surrounding the shoulder girdle, including the clavicle and scapula, primarily stabilize the scapula. This stable base allows other muscles to move the humerus effectively. Scapular movements often mirror those of the humerus and extend its range of motion. For instance, raising the arm above the head would not be feasible without simultaneous upward rotation of the scapula.
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Informed Consent in Shoulder and Elbow Surgery.

Puru Sadh1, Antonio Almeda-Lopez2, Benjamin Hershfeld3,4,1

  • 1Department of Orthopaedic Surgery, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, USA.

Cureus
|October 22, 2025
PubMed
Summary

Informed consent in shoulder and elbow surgery is inconsistent, facing barriers like low health literacy and time constraints. Patient-centered strategies are needed to improve understanding and reduce medicolegal risks.

Keywords:
elbow surgeryinformed consentmalpracticemedicolegalpatient autonomyshoulder surgeryupper extremity

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Area of Science:

  • Orthopaedic Surgery
  • Patient Safety
  • Medical Ethics

Background:

  • Informed consent is crucial for patient autonomy but is inconsistently applied in orthopaedic surgery.
  • Shoulder and elbow procedures have unique challenges impacting consent due to complex outcomes and medicolegal risks.
  • Limited evidence exists on current informed consent practices in shoulder and elbow surgery.

Purpose of the Study:

  • To review the literature on informed consent in shoulder and elbow surgery.
  • To identify barriers to effective communication and patient understanding.
  • To highlight strategies for improving informed consent processes.

Main Methods:

  • A systematic literature search was conducted on PubMed, Web of Science, and Scopus.
  • Eligible studies focused on informed consent quality, comprehension, expectations, interventions, or medicolegal outcomes in shoulder and elbow surgery.
  • Studies not directly addressing informed consent in this subspecialty were excluded.

Main Results:

  • Quantitative data on consent quality is limited, despite high malpractice rates linked to inadequate consent.
  • Key barriers include low health literacy, language discordance, insufficient physician training, and time constraints.
  • Patient expectations vary significantly, necessitating individualized consent discussions.

Conclusions:

  • Multifaceted, patient-centered approaches are proposed, including teach-back, plain language, visual aids, structured training, interpreter services, and workforce diversity.
  • Future research should validate specialty-specific frameworks, integrate digital tools, and use quantitative outcome measures.
  • System-wide implementation can enhance autonomy, trust, reduce medicolegal risk, and improve surgical outcomes.