Informed Consent: Still Far from Ideal?

Ladas, Spiros D.

doi:10.1159/000094527

Cited by 11 publications

(11 citation statements)

References 17 publications

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“…Thus, the doctrine of informed consent focuses on the content and process of consent [5] . The issue of informed consent being far from ideal was discussed in a paper by Ladas [6] , published recently. In this paper, the author emphasized that the process of informed consent requires that the doctor explains to the patient the benefits and risks of any suggested test or treatment and obtains the patient's deliberate agreement to proceed.…”

Section: Discussionmentioning

confidence: 99%

“…Only 11.5% of endoscopists discussed mortality rate; that possibly reflects the experience of a very sensitive issue for the patients, immediately before the procedure. Thus, the crucial unresolved issue is the amount of information about the complication and mortality rates of endoscopic procedures with which the endoscopist should provide the patient [6] . The results of several published surveys brought up different observations, ranging from the fact that most patients wish to be informed of a risk greater than 1: 1,000 to the fact that 19% of gastroscopy patients wanted to know all possible complications [16,17] .…”

Section: Discussionmentioning

confidence: 99%

“…This could represent the feeling of stressed responsibility that was put on the leader of the endoscopic team performing the procedure, in the setting of lack or inappropriate by-laws and local guidelines [18] . As stated in the paper by Ladas [6] , the workload of endoscopic procedures has very much increased over the past 30 years, but the lack of the doctor's time is not an excuse for violating the patient's rights and doctor's ethical obligations.…”

Section: Discussionmentioning

confidence: 99%

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Informed Consent for Gastrointestinal Endoscopy: A View of Endoscopists in Croatia

Banić¹,

Kardum²,

Pleško³

et al. 2008

Dig Dis

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Background/Aim: There are many differences and deficiencies in the process of informed consent. The aim of this study was to get the view of gastrointestinal endoscopists in Croatia on obtaining patients’ consent before endoscopic procedures. Methods: During the 2004 annual meeting of the Croatian Society of Gastroenterology, endoscopists were asked to answer a questionnaire according to common clinical practice in affiliated institutions. It included questions on endoscopists’ experience and education in medical ethics, as well as on the nature and quality of information given to patients and their opinion on proposed measures for improvement of the informed consent process. Results: The questionnaire was distributed to 96 endoscopists attending the meeting and the response rate was 54% (52/96). In only 50% of institutions was the obtained consent written and potential complications of endoscopic procedures are occasionally given to the patient. In the minority of cases the patient is provided with information about alternative diagnostic tests and/or treatment options, and the information about mortality rate was almost never discussed. Conclusions: In Croatia, the process of informed consent for endoscopy needs improvement and should be regarded against the background of education in medical ethics, regional burden in endoscopic practice and appropriateness of by-laws and local guidelines.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Informed Consent for Gastrointestinal Endoscopy: A View of Endoscopists in Croatia

Banić¹,

Kardum²,

Pleško³

et al. 2008

Dig Dis

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“…Besides, properly informed patients seldom sue. Busy endoscopy units and long waiting lists for gastroscopy are not an excuse of skipping proper patient information [26, 27] and not asking their preference for sedation.…”

Section: Discussionmentioning

confidence: 99%

Use of Sedation for Routine Diagnostic Upper Gastrointestinal Endoscopy: A European Society of Gastrointestinal Endoscopy Survey of National Endoscopy Society Members

Ladas¹,

Aabakken²,

Rey³

et al. 2006

Digestion

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Background/Aims: Sedation rates may vary among countries, depending on patients’ and endoscopists’ preferences. The aim of this survey was to investigate the rate of using premedication for routine diagnostic upper gastrointestinal (UGI) endoscopy in endoscopy societies, members of the European Society of Gastrointestinal Endoscopy (ESGE). Methods: We evaluated a multiple-choice questionnaire which was e-mailed to representatives of national endoscopy societies, which are members of the ESGE. The questionnaire had 14 items referring to endoscopy practices in each country and the representatives’ endoscopy units. Results: The response rate was 76% (34/45). In 47% of the countries, less than 25% of patients undergo routine diagnostic UGI endoscopy with conscious sedation. In 62% of the responders’ endoscopy units, patients are not asked their preference for sedation and do not sign a consent form (59%). Common sedatives in use are midazolam (82%), diazepam (38%) or propofol (47%). Monitoring equipment is not available ‘in most of the endoscopy units’ in 46% (13/28) of the countries. Though they were available in 91% of the national representatives’ endoscopy units, they are rarely (21%) used to monitor unsedated routine diagnostic UGI endoscopy. Conclusions: In about 50% of ESGE-related countries, less than 25% of patients are sedated for routine diagnostic UGI endoscopy. Major issues to improve include availability of monitoring equipment and the use of a consent form.

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“…Moreover, although much work has been published on the moral and ethical issues about informed consent in Western countries [7, 8], there is no literature on physicians’ consent behaviors in the practice of informed consent for endoscopic procedures in China. In early 1999, the British Society of Gastroenterology [9] issued guidelines for informed consent for endoscopic procedures and noted that the patient should be fully informed by the endoscopist, ideally at least 24 h before the procedure, and then be asked to sign a consent form; however, it has been noted that there were considerable drawbacks in the process of informed consent for gastrointestinal endoscopic procedures in many European countries [10]. Therefore, we evaluated the daily practice of informed consent prior to endoscopic procedures and assessed patient satisfaction with such procedures by conducting a prospective, multicenter survey on informed consent for gastrointestinal endoscopy in tertiary endoscopic units in China.…”

Section: Introductionmentioning

confidence: 99%

A Multicenter Prospective Survey on Informed Consent for Gastrointestinal Endoscopy in China

et al. 2007

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Background/Aim: Data on informed consent procedures in endoscopy centers in China are lacking. The aim of this study was to record the current status of informed consent procedures in four tertiary endoscopy centers in China. Methods: All patients underwent upper gastrointestinal endoscopic examinations in four tertiary endoscopy centers in China from August 2006 to October 2006. Data on patients’ age, gender, education level, type of endoscopic procedures, complication rates, and satisfaction were recorded prospectively. Results: Totally, 1,303 patients were included (mean age 47.7 years, 50.2% males, 88.3% outpatients, 13.1% with university education) and underwent 1,308 endoscopic procedures. Of these patients, 994 were informed prior to the endoscopic procedures; the remaining patients were not asked for their oral or written informed consent before the procedure. No serious complications occurred, but 9 patients were not satisfied with the procedures and 5 patients refused to complete the endoscopic examination. Conclusions: Gastrointestinal endoscopic examinations, especially diagnostic gastroscopy, are safe, carrying minimal patient risk, but the current practice of informed consent procedures in China is suboptimal. More efforts should be made to improve the standards of informed consent for endoscopic procedures in China.

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Informed Consent: Still Far from Ideal?

Cited by 11 publications

References 17 publications

Informed Consent for Gastrointestinal Endoscopy: A View of Endoscopists in Croatia

Informed Consent for Gastrointestinal Endoscopy: A View of Endoscopists in Croatia

Use of Sedation for Routine Diagnostic Upper Gastrointestinal Endoscopy: A European Society of Gastrointestinal Endoscopy Survey of National Endoscopy Society Members

A Multicenter Prospective Survey on Informed Consent for Gastrointestinal Endoscopy in China

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