Geriatricians’ Standpoint of the Informed Consent Process Among Patients with Alzheimer's Disease: The Lebanese Context

Abstract

BackgroundDespite the existence of laws that ensure that patients’ capacity to consent is assessed systematically, many gray areas remain with that regard. As dementia progresses, some patients lose their capacity to make decisions. This study aimed to investigate the geriatricians’ understanding of the principle of autonomy and their perception of the decision-making capacity (DMC) testing as part of the informed consent (IC) process among patients with AD. Proposing an algorithm for a reliable, comprehensive, and valid assessment of DMC was the secondary aim of this study.MethodsA cross-sectional descriptive study was designed to empirically collect data via an e-survey. Accordingly, a comprehensive list of geriatricians was provided by the Lebanese Order of Physicians. Geriatricians were approached via a phone call, to provide them with study-specific information. Those who accepted to participate received a link to the study’s survey via an e-mail.ResultsAmong the eligible geriatricians, 75% had completed the e-survey, with a mean of 14.7 ± 9.6 years of experience. More than half of the geriatricians failed to recognize that assessing the patients’ DMC is an integral component of the informed consent (IC) process. Yet, 88.9% assessed the DMC of their patients with AD using different modalities. However, the majority were unable to justify their judgment of DMC based on the tools they have selected.ConclusionLebanese geriatricians have demonstrated a poor understanding of the concept of autonomy and failed to recognize the need for the DMC assessment as a component of the IC’s process. Moreover, they were unable to select adequate tools to assess and judge the DMC of their patients with AD.