THE STANDARD OF INFORMED CONSENT IN ELECTIVE SURGERY - AN OBSERVATIONAL STUDY FROM A TERTIARY HEALTHCARE FACILITY

Objectives: To evaluate the practice and patient’s perception of informed consent before elective surgery in Tertiary Health Care setup. Methodology: This questionnaire based observational study was conducted in Surgical Department of Khyber Teaching Hospital Peshawar from April 2009 to August 2009. Standard questionnaires were handed over during their stay in the hospital to the patients who had undergone elective surgery. Independent variables of our study were age, educational level and socioeconomic status. Dependent variables were knowledge about the disease, treatment options, alternatives, what if no treatment, type and risk of anesthesia and postoperative complications and their management, the consent taking authority, their satisfaction about the information given and whether the consent form was signed by the patients themselves or their attendants. Results: In our study on 37 (24.33%) patients the consent was obtained by the concerned surgeon while in 113 (75.33%) patients consent was taken by some junior doctors (trainee medical officers or house surgeons). Disease was explained to 105 (70%) patients and various treatment options to 67 (44%) patients. One hundred thirty five (90%) patients were informed about the complications of their surgical treatment. Contrary to our expectations 110 (73.33%) patients expressed their satisfaction with the information given to them about their surgical management. Informed consent was signed by all (100%) the patients. Conclusion: The current informed consent practice in our surgical setup is deficient as far as the international, legal and ethical standard is concerned. We think further measures should be taken to involve the concerned surgeon and enhance patient’s understanding of informed consent for surgery.