Sign on the dotted line: parental consent

Abstract

The issue of informed consent in paediatric surgery has always been contentious. Despite the fact that taking consent is one of the most frequently performed tasks of a surgeon, it is rarely audited. Indeed, there are few studies looking at the consent process in adult practice and fewer in the paediatric setting. The aim of this study was, therefore, to determine parental understanding, recall, attitudes and opinion of the consent process in a busy paediatric day surgery unit. A prospective study was conducted using a questionnaire consisting of 20 questions. These were handed out to the parents of all children undergoing one of four procedures: circumcision, prepuceplasty, orchidopexy and herniotomy over a 3-month-period. Completed questionnaires were collected and analysed. One hundred and sixty-one parents were asked to complete the questionnaire. Ninety-three were collected, a response rate of 58%, 87% believed consent was taken by the performing surgeon, 15% felt the consent process was rushed, but 91% thought the right amount of detail was given. Ninety-seven percent of parents believed that the consent form was a legal necessity and 72% believed that a child in Scotland had to be aged 16 or over to sign the consent form. Interestingly, 23% of parents were unsure if signing the consent form meant that they could not claim compensation if anything went wrong. Ninety-one percent recalled the procedure being explained in the outpatient clinic, but 22% did not remember potential complications being discussed. The amount parents recalled of potential complications varied. Seventy percent felt that a leaflet about the procedure prior to attending the unit would be helpful. In conclusion consent is an extremely important part of our practice. This study highlights some of the common parental misconceptions and limitations of the process. Parents appear satisfied and consenting for procedures is overall performed well. Some areas could be improved and more research is required in this area.

Parental Recall of Anesthesia Information

“…Indeed, in our study, only one-third of parents recalled being told about the different anesthetic options (when an option was available) and only half were told about the risks and benefits. These results are similar to data from other areas of medicine,20–23 suggesting a general difficulty of many patients to recall or understand medical information. While an absence of recall does not necessarily imply an absence of informed consent, recall partially depends on comprehension24 and may have implications for parental care of the child postoperatively.…”

Parental Perceptions About Informed Consent/Assent in Pediatric Research in Jordan

“…All parents agreed that detailed information about the topic, including the benefits and possible harms, aims of the project, and research team qualifications and detailed contact information, should be provided. Previous studies have shown that providing enough clear information about the benefits, risks, and study procedures increased parental satisfaction (Kupst, Patenaude, Walco, & Sterling, 2003; Steven, Broadis, Carachi, & Brindley, 2008; Stolt, Helgesson, Liss, Svensson, & Ludvigsson, 2005) and enhanced enrollments of children in pediatric research, to include clinical studies (Bernhardt, Tambor, Fraser, Wissow, & Geller, 2003; Boccia, Campbell, Goldman, & Skinner, 2009; Eder, Yamokoski, Wittmann, & Kodish, 2007; van Stuijvenberg et al, 1998). It is strongly recommended that more studies be conducted on this aspect to evaluate the quality of the provided information and informed consent procedures when conducting pediatric and other types of research in Jordan and the Arabic region.…”

Informed Consent in Pediatric Otolaryngology

“…[5][6][7][8][9][12][13][14] A study in pediatric surgery, for example, found that .20% of parents did not recall any risks being discussed, and \40% recalled the commonly mentioned risks, such as bleeding and infection. 13 However, no studies to date have used objective assessment of the consultation interaction and recall of the information discussed during the visit. Specifically, previous research has relied on what the physician remembered stating, sometimes along with an educational aid, as the information given during the consultation and relating it to what was recalled by patients and family members.…”

“…[5][6][7][8][9] Even after undergoing a detailed informed consent process, patients and family members have demonstrated poor recall of the risks discussed during surgical consultations. [9][10][11][12][13] Thus, a need exists to better understand the informed consent process in pediatric otolaryngology and determine what factors may influence recall of the information discussed during surgical consultations.…”