English law for the surgeon I: Consent, capacity and Competence

Jerjes, Waseem; Mahil, Jaspal; Upile, Tahwinder

doi:10.1186/1758-3284-3-41

Cited by 6 publications

(6 citation statements)

References 6 publications

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“…It constituted a simple question concerning the treatment method that the patient was required to answer with a yes or no, in order to determine if an agreement was established and the surgeon could proceed with performing the operation. 3 The driving force for the evolution of consent originated from patient's dissatisfaction and frustration that provoked subsequent complaints in regard to the outcome of the operation. Due to the lack of thorough explanation of the medical procedure or omissions in interpretation of the anticipated consequences following intervention, patients were prone to complain about the outcome.…”

Section: Discussionmentioning

confidence: 99%

“…ascertaining the patient's approval through the IC is imperative. 3 The development of the IC term may lead to conflicts between doctors and patients, but the final outcome should be the collaboration that will ascertain the fine balance between the physician acting on the patient's best medical interest while respecting his human rights. [4][5][6] Enormous steps towards optimization have been reported from the ancient times to the Amsterdam declaration.…”

Section: Introductionmentioning

confidence: 99%

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Are patients willing to be informed on the risks and complications associated with the proposed therapy? A survey on informed consent

Dafni¹,

Οικονόμου²,

Αναγνωστόπουλος³

et al. 2021

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Introduction: Informed consent is essential to the patient-physician relationship. The paternalistic old-time approach used by physicians to achieve the optimal management is changing today; detailed medical information must be disclosed to the patients regarding their health problem. Aim: The aim of this study was to highlight the value of informed consent in the context of medical practice as well as to emphasize its importance through the prism of human rights. Materials and methods: A patient survey was conducted in two public and one private hospitals in Greece. Eighty-three inpatients from the Surgical Departments of Democritus University Hospital of Alexandroupolis (DUHA), Laikon University Hospital of Athens (LUHA) and a private hospital were included in the study. A questionnaire regarding patients’ attitude towards informed consent was distributed to patients prior to surgery. Results: The majority of the patients (63.86% in DUHA, 59.38% in LUHA, and 78.95% in the private hospital) opted for full disclosure regarding the course and development of their condition. Conclusion: Patients want to be informed about their treatment options and possible complications so that they can make decisions about their treatment after a comprehensive and understandable discussion.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Are patients willing to be informed on the risks and complications associated with the proposed therapy? A survey on informed consent

Dafni¹,

Οικονόμου²,

Αναγνωστόπουλος³

et al. 2021

View full text Add to dashboard Cite

show abstract

“…This concept has been readily adapted into other areas affecting children's lives—including healthcare 14 15. Decision making in paediatrics is based on application of the ‘best interests’ principle,16 17 the welfare checklist element remains influential:…”

Section: Background Considerationsmentioning

confidence: 99%

Adolescent autonomy revisited: clinicians need clearer guidance

Brierley

Larcher

2016

J Med Ethics

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In 1996, Brazier and Bridge raised the question 'is adolescent autonomy truly dead and buried' following judicial decisions which had seemed to reverse the Gillick-inspired trend for greater child autonomy in healthcare. Subsequent decisions by the courts have reinforced the view that those below 18 years in England and Wales remain children with limited rights to refuse treatment compared with adults. This is at variance with the daily experience of those working with young people who increasingly seek to actively involve them in making freely informed decisions about their healthcare, in accordance with the principles enunciated in the UN Convention of the Rights of the Child and the UK Children Acts. We review the derivation of the law in England and Wales in this area, in the light of another recent family court judgement enforcing treatment on a 'competent' child without his or her consent and ask: 'How can the Common Law and the ethical practice of those caring for young people have diverged so far?' Either young people can decide whether to have a recommended treatment, or they cannot. Given Ian McEwan's book, the Children Act, has stimulated wider social debate in this area might this be an opportune moment to seek public policy resolution with regards to healthcare decision making by young people? We argue that events since the Gillick case have underlined the need for a comprehensive review of legal policy and practice in this area. While absolute autonomy and freedom of choice are arguably inconsistent with the protection rights that society has agreed are owed to children, healthcare practitioners need clarity over the circumstances in which society expects that autonomous choices of adolescents can be overridden.

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“…20 This decision is universally accepted as a "waiver of informed consent" or "exception from informed consent" in emergency care. 13,20,21 In fact, Chinese healthcare practitioners are required to obtain informed consent from patients or relatives prior to emergency surgery, although Chinese Civil Code indicates that it is legal to give treatment to a person without informed consent on the premise that the person is in life-threatening condition and it is impossible to obtain the person's or a relative's consent. 12 Notably, in contrast to Western law, patients' families are granted the same right to decide as that granted to the patients themselves and sometimes even play a dominant role in China.…”

Section: Introductionmentioning

confidence: 99%

Exploring the delay in the informed consent procedures of patients with ST-segment elevation myocardial infarction undergoing percutaneous coronary intervention: Is it worth the wait?

Maimaitiming

Dong

et al. 2022

Preprint

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Objective:To investigated the factors associated with informed consent delay in patients with ST-segment elevation myocardial infarction (STEMI) undergoing percutaneous coronary intervention (PCI) and the association between the delay and door-to-balloon time. Methods:We conducted a nationally representative retrospective cohort study using patient data reported by hospital-based chest pain centers from 1 January 2016 to 31 December 2020. Results: In total, 257,510 patients were enrolled in the analysis. Mean informed consent delay time was 22.4 minutes, accounting for 39.3% in door-to-balloon time. Older age (≥65 years) was significantly correlated with informed consent delay time (RR: 1.034, p=0.001). Compared with ethnic Han patients, the minority (RR: 1.146, p<0.001) had more likelihood to extend consent giving; compared with patients who were single, longer informed consent time was found in married patients (RR: 1.054, p=0.006). Patients with intermittent chest pain (RR: 1.034, p=0.011), and chest pain relief (RR: 1.085, p=0.005)were more likely to delay informed consent. As for transfer modes, EMS (RR: 1.063, p<0.001), transfer-in (RR: 1.820, p<0.001), and in-hospital onset (RR: 1.099, p=0.002) all had positive correlations with informed consent delay time compared to walk-in. Informed consent delay was significantly associated with prolonged door-to-balloon time (OR: 1.002, p<0.001). Conclusion: Informed consent delay provokes prolongation of emergency treatment delay, which potentially leads to poor outcome of STEMI patients. It is essential to shorten the delay time by identifying and intervening modifiable factors that are associated with shortening the informed consent procedure in China and other countries.

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English law for the surgeon I: Consent, capacity and Competence

Cited by 6 publications

References 6 publications

Are patients willing to be informed on the risks and complications associated with the proposed therapy? A survey on informed consent

Are patients willing to be informed on the risks and complications associated with the proposed therapy? A survey on informed consent

Adolescent autonomy revisited: clinicians need clearer guidance

Exploring the delay in the informed consent procedures of patients with ST-segment elevation myocardial infarction undergoing percutaneous coronary intervention: Is it worth the wait?

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