An Audit of Information Provided during Preoperative Informed Consent

Objective: To find out preoperative informed consent practice in a tertiary care public sector teaching hospital. Settings: General Surgical Units of Civil Hospital Karachi Design: Prospective observational study. Duration: January 2005 to March 2005 Patients and Methods: Patients who had undergone elective surgery were interviewed randomly during the study period under routine practice conditions. All the patients were asked a set of standard questions post operatively related to the information they were provided before the procedure as a part of standard informed consent practice. Questionnaire included the patient’s knowledge about pathology, operative risks, type of anaesthesia given with its risks, alternate treatment option, results of no treatment, patient’s satisfaction about the information given and whether consent form was signed. Results: A total of 200 randomly chosen patients (121 males and 79 females) were included in the study. In 16 (8%) of patients the operative surgeons were involved in taking consent themselves. Only 90 (45%) of patients were told about the nature and purpose of procedure and 89 (44.5%) of patients knew about the possible complications of surgery. 143 (71.5%) of patients were told about the type of anesthesia required but only 30 (15%) were informed about the risks of anaesthesia. 40 (20%) of patients were allowed questions to be asked while taking consent. Interestingly, most of the patients 156 (78%) were still satisfied by the information provided to them during informed consent. Conclusion: This study highlights the poor quality of patient knowledge about surgical procedures and the scarce information provided. The current informed consent practice which is being practiced by the doctors in a public sector teaching hospital of Karachi is below standard to international and ethical acceptability. Yet, a large number of patients were satisfied by the information provided during the informed consent process.