The perspectives of eThekwini public service anaesthetic doctors on the informed consent process for anaesthesia
AbstractObjectives: This study aimed to ascertain the perspectives of anaesthetists with regard to their current practice of obtaining informed consent. The outcome of this study will eventually assist in creating a standardised system for informed consent which will be pivotal to the safe, ethical, medical and legally sound practice of anaesthesia.
Design: This was an observational descriptive study that assessed the perspectives of anaesthetists in public service using manually and electronically distributed questionnaires that consisted of open- and closed-ended questions.
Setting and subjects: The study canvassed the views of full-time anaesthetic doctors employed by state hospitals in the eThekwini municipality.
Outcome measures: The practice, general impression and overall skills in respect of informed consent obtained by anaesthetists were measured in four main areas: the preanaesthetic interview, optimisation of the process, influence of litigation on the process, and expertise in determining patients’ competence for consent in 12 clinical scenarios.
Results: The current system of informal verbal consent was found to be unsatisfactory by 78.3% of the doctors. Most doctors (83.8%) advocated the recording of written consent on a specific anaesthetic consent form. While 93.8% of doctors were aware of the legal implications of not obtaining written consent, 61.8% of them admitted to not documenting important anaesthetic information. A doctor’s ability to determine his or her patient’s capacity to provide informed consent was determined by using a range of carefully constructed clinical scenarios. This assessment revealed that there were several areas of deficiency in respondents’ knowledge.
Conclusion: The current process of obtaining informed consent for anaesthesia has been deemed by doctors in eThekwini to be substandard and legally indefensible. The process should be improved and standardised by creating a specific anaesthetic consent form on which written consent can be documented.
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