Improving the patient informed consent process

San Francisco Obtaining and documenting informed patient consent prior to surgery is of vital importance, but both the process and documentation of consent can be inadequate.

Today at the annual meeting of the American Association of Neurological Surgeons in San Francisco, physicians from the University of Pittsburgh Medical Center reported on a study of a procedure-based consent form they have developed to enhance and improve this process.

"Appropriate physician conduct in medical/legal matters begins with the informed consent process. This leads to an understanding of the patient's diagnosis, the planned procedure, the therapeutic alternatives - both medical and surgical, and the inherent procedural risks," reported Douglas Kondziolka, M.D., Peter J. Jannetta Professor and vice-chairman of neurological surgery, and professor of radiation oncology at the University of Pittsburgh School of Medicine. "It has been argued that most surgeons do not devote appropriate importance to informed consent in their daily duties. The patient consent procedure we developed facilitates patient discussion and we validated this process by surveying our patients on various elements of the consent process."

In the study, 120 consecutive patients were evaluated prior to different neurological surgery procedures. Two consent forms were used by the surgeon; one was a standard hospital consent form, and the other was a specialized form created for the neurological surgery practice. This specialized consent form listed specific diagnoses, procedures, alternatives and risks. Each point discussed with the patient was checked off by the surgeon. The form then was signed by both the patient and the surgeon. Ten to twenty minutes later, the patient was questioned by a non-medical member of the office staff.

All of the 120 patients using the new form correctly recalled their diagnoses and the procedure they were going to receive. The diagnoses included brain tumo


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