• We are sorry, but NCBI web applications do not support your browser and may not function properly. More information
Logo of jmedethJournal of Medical EthicsVisit this articleSubmit a manuscriptReceive email alertsContact usBMJ
J Med Ethics. Jun 2001; 27(3): 157–161.
PMCID: PMC1733399

The process of informed consent for urgent abdominal surgery

Abstract

Objectives—To assess perceptions of the informed consent process in patients undergoing urgent abdominal surgery.

Design—A prospective observational study was carried out using structured questionnaire-based interviews. Patients who had undergone urgent abdominal surgery were interviewed in the postoperative period to ascertain their perceptions of the informed consent process. Replies were compared to responses obtained from a control group undergoing elective surgery, to identify factors common to the surgical process and those specific to urgent surgery. Patients' perceptions of received information were also compared to the information perceived to have been provided by the consent obtainers.

Setting—Gastrointestinal surgical service of a university teaching hospital.

Patients—Seventy-four consecutive patients undergoing urgent abdominal surgery and 80 control patients undergoing elective surgery.

Main measurements—Principal outcome measures were patients' perceptions of factors interfering with the ability to give informed consent, assessment of the quality of informed consent and the degree of discussion of the expected outcomes.

Results—Forty-nine of the seventy-four (66%) patients undergoing urgent surgery perceived that pain did not affect their ability to give informed consent. Twenty-seven reported an adverse effect of analgesia on the ability to give informed consent. Only 22% of patients undergoing urgent surgery perceived that there had been any discussion of potential side effects and complications of surgery.

Conclusion–The majority of patients in this series with acute intra-abdominal surgical conditions perceive that they retain the ability to give informed consent for surgery. There is a need for improved discussion of therapeutic options and likely outcomes.

Key Words: Informed consent • urgent abdominal surgery

Full Text

The Full Text of this article is available as a PDF (111K).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Vessey W, Siriwardena A. Informed consent in patients with acute abdominal pain. Br J Surg. 1998 Sep;85(9):1278–1280. [PubMed]
  • Folstein MF, Folstein SE, McHugh PR. "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975 Nov;12(3):189–198. [PubMed]
  • Hekkenberg RJ, Irish JC, Rotstein LE, Brown DH, Gullane PJ. Informed consent in head and neck surgery: how much do patients actually remember? J Otolaryngol. 1997 Jun;26(3):155–159. [PubMed]
  • Myles PS, Fletcher HE, Cairo S, Madder H, McRae R, Cooper J, Devonshire D, Hunt JO, Richardson J, Machlin H, et al. Randomized trial of informed consent and recruitment for clinical trials in the immediate preoperative period. Anesthesiology. 1999 Oct;91(4):969–978. [PubMed]
  • Johnson RC, Pye JK, Scriven MW, Billings PJ, Wood C, Crumplin MK. Patients' perception of surgical services in a district general hospital. Br J Surg. 1999 Dec;86(12):1549–1555. [PubMed]
  • Kriwanek S, Armbruster C, Beckerhinn P, Blauensteier W, Gschwantler M. Patients' assessment and recall of surgical information after laparoscopic cholecystectomy. Dig Surg. 1998;15(6):669–673. [PubMed]
  • Sauerland S, Lefering R, Holthausen U, Neugebauer EA. Laparoscopic vs conventional appendectomy--a meta-analysis of randomised controlled trials. Langenbecks Arch Surg. 1998 Aug;383(3-4):289–295. [PubMed]
  • Lo CM, Liu CL, Fan ST, Lai EC, Wong J. Prospective randomized study of early versus delayed laparoscopic cholecystectomy for acute cholecystitis. Ann Surg. 1998 Apr;227(4):461–467. [PMC free article] [PubMed]
  • Angelos P, DaRosa DA, Derossis AM, Kim B. Medical ethics curriculum for surgical residents: results of a pilot project. Surgery. 1999 Oct;126(4):701–707. [PubMed]
  • Nandi PL. Ethical aspects of clinical practice. Arch Surg. 2000 Jan;135(1):22–25. [PubMed]
  • Newton-Howes PA, Bedford ND, Dobbs BR, Frizelle FA. Informed consent: what do patients want to know? N Z Med J. 1998 Sep 11;111(1073):340–342. [PubMed]
  • Osuna E, Pérez-Cárceles MD, Pérez-Moreno JA, Luna A. Informed consent. Evaluation of the information provided to patients before anaesthesia and surgery. Med Law. 1998;17(4):511–518. [PubMed]

Articles from Journal of Medical Ethics are provided here courtesy of BMJ Group

Formats:

Related citations in PubMed

See reviews...See all...

Cited by other articles in PMC

See all...

Links

  • PubMed
    PubMed
    PubMed citations for these articles

Recent Activity

Your browsing activity is empty.

Activity recording is turned off.

Turn recording back on

See more...