Informed consent: What do patients want to know?

Abstract

Aim. To determine which aspects of informed consent are important to patients and surgeons and to determine where there is disparity and similarity. Method. A questionnaire was developed from the Disability Commissioner's Regulations (1996) and was administered to 256 patients and 37 doctors at Christchurch Hospital. Results. According to patients the five most important aspects of informed consent were: (1) the major risks, (2) quality of life, (3) outcome, (4) consequences of not undergoing the procedure and (5) quantity of life. The five most important aspects to the doctors were (1) the general nature of the procedure, (2) major risks, (3) consequences of not undergoing the procedure, (4) alternative options and (5) consequences of the procedure in regard to management. The aspects of informed consent of greatest divergence (power of divergence, p<0.05) between patient and doctor were (1) the importance of technical details of the procedure, (2) cost to the country, (3) qualifications of the doctor, (4) experimental and non-conventional treatment options and (5) whether the doctor would have the procedure if they were in the position of the patient. Conclusions. This study has identified aspects of informed consent that patients and doctors consider important, as well as aspects where there are significant differences. Both patients and doctors consider the explanations of risks and complications important, especially if the complication is serious and risk is greater than 1 in 1000. Patients consider aspects of outcome (quantity and quality of life) important, while doctors are concerned about "process" including the general nature of the procedure and consequences of the procedure for the patient's management. This study gives direction to medical practitioners concerning what it is that patient's are wanting to know during informed consent about a procedure.