Difficulties in obtaining informed consent by psychiatrists, surgeons and obstetricians/gynaecologists

Health-care professionals’ knowledge, attitudes and behaviours relating to patient capacity to consent to treatment

“…This percentage was highest for nurses 21 and psychiatrists 35 in the respective studies. In two studies that explored issues relating to valid consent, the presence of capacity was not recognised as a requisite of a legally valid consent by one-third of psychiatry, obstetrician/gynaecology and surgeon respondents in the United Kingdom, 38 and a fluctuating capacity was not recognised as something that could compromise a valid consent in a study of doctors from Malaysia and India (40% (n = 20) and 36% (n = 17), respectively). 22…”

“…Perceived patient incapacity and treatment refusal were identified by HCPs across a range of medical specialties in one study as the most common situations in which gaining consent was problematic. 38 Two studies from Turkey identified that 83.6% (n = 179) of physicians and 58.1% (n = 96) of nurses, respectively, would override the previously expressed wishes of a patient with capacity following a loss of consciousness, 33 or would lie or manipulate the truth for the sake of a patient’s well-being, when presented with a scenario of a patient refusing treatment based on religious grounds. 36 Carrying out treatment despite a patient’s expressed wishes to do otherwise was found to be supported by 19% (n = 96) of intensive-care physicians in a European study 46 and 13.7% (n = 28) of medical and surgical physicians in a Turkish study.…”

“…For example, the MMAT cut-off for response rate within studies is 60%. This meant that the studies by Kent, 38 Vincent, 46 Ganzini et al 34 and Ersoy and Gündogmus, 33 with response rates of 32%, 40%, 53% and 32%, respectively, received MMAT ratings of 75%. This cut-off may be more unfair on the studies by Vincent 46 and Ganzini et al, 34 as the sampling strategies within these studies involved European and US national association memberships, respectively.…”

Past, Present, and Future of Informed Consent in Pain and Genomics Research: Challenges Facing Global Medical Community

“…Every informed consent can only be valid when 2 key conditions are satisfied: (1) the information provided to the subject and (2) the consent of the subject . There is a robust body of literature specifying the limitations of informed consent to obtain these targets . A vital point is the question of how much information is essential for the patient to be considered “informed” and whether this information can affect the results of the study, especially in patients with chronic pain for whom a placebo effect could be of great importance.…”