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. The aim was to characterize Lebanese geriatricians’ perspectives about decision-making capacity (DMC) of their patients with Alzheimer’s disease (AD). Moreover, to propose an algorithm for a reliable, comprehensive, and valid assessment of DMC. 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 successfully 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 clearly 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 the need for the DMC assessment as part of the IC’s process. Moreover, they were unable to select adequate tools to assess and judge the DMC of their patients with AD.