Ethical aspects of informed consent in obstetric anesthesia—new challenges and solutions

What a signature adds to the consent process

“…It is, however, also supported by studies demonstrating that the more information given, the calmer the patient facing surgery becomes [23]. However, it may be unclear just how much information should be imparted [24,25], and there may be significant geographic variation in the amounts detailed [26]. In some countries, particularly the United States, written consent is an integral part of everyday practice, although many patients misunderstand the actual intention of the process [27].…”

Informed consent for labor epidurals: a survey of Society for Obstetric Anesthesia and Perinatology anesthesiologists from the United States

“…It may indeed be possible for a parturient in active labor to give permission to have the epidural procedure done, 2,9,10 although it may not be the best time for her to be informed and educated about it. 2,[11][12][13] It is often suggested that the optimal time to inform and educate pregnant women about labor analgesia is before labor begins. Therefore, a better alternative may be for anesthesiologists to discuss anesthesia care with pregnant women antenatally whenever possible.…”

“…In a recent review on the ethical aspects of informed consent in obstetric anesthesia, the author suggests that "one obvious solution to many of the problems involved with informed consent in obstetric anesthesia is adequate antenatal education." 12 In contrast, some have the view that only during labor, when the severity of pain has been experienced, can a woman fully weigh the risks and benefits of epidural analgesia and give informed consent. Jackson et al discuss the idea that the process of informed consent for labor epidural analgesia may need to become a two-part process: while pain-free for the risks and during labor for the benefits.…”

Women need to be told ALL the risks before regional techniques are performed

“…Adequate disclosure is a fundamental duty; it alone empowers patients to be autonomous in their decision-making 7 and provide adequate informed consent. 8 It is thus ethically unacceptable to withhold information from parturients and limit their ability to consent.…”