Fisher-Jeffes Lisa, Barton Charlotte, Finlay Fiona
Royal United Hospital, Combe Park, Bath, UK.
J Med Ethics. 2007 Mar;33(3):181-4. doi: 10.1136/jme.2006.016758.
To audit doctors' knowledge of informed consent.
10 consent scenarios with "true", "false", or "don't know" answers were completed by doctors who care for children at a large district general hospital. These questions tested clinicians' knowledge of who could give consent in different clinical situations.
Royal United Hospital, Bath, UK.
51 doctors participated (25 paediatricians and 26 other clinicians). Paediatricians scored higher than other clinicians (average correct response 69% v 49%). Only 36% (9/25) of paediatricians and 8% (2/26) of other clinicians realised that the biological father of a child born before 1 December 2003 needed a court order or a parental responsibility agreement to acquire parental responsibility, and thus be able to consent on behalf of his child, if he was not married to the child's mother. Non-paediatric clinicians were unsure or incorrect when tested on situations where people with parental responsibility do not agree, or where young people (<16 years), who are Fraser competent do not want to consult their parents. Most clinicians did not know that the parents of a 20-year-old man with severe learning difficulties are unable to consent to surgery on his behalf, and many non-paediatricians were unclear on who could give consent when a child lived with foster parents.
Clinicians who obtain consent for the treatment of children need to increase their knowledge on who is able to give informed consent to ensure best (legal and safe) practice.
审核医生对知情同意的认知情况。
一家大型地区综合医院中负责照料儿童的医生完成了10个包含“正确”“错误”或“不知道”答案的同意情景测试。这些问题考查了临床医生在不同临床情况下谁能给予同意的知识。
英国巴斯皇家联合医院。
51名医生参与(25名儿科医生和26名其他临床医生)。儿科医生的得分高于其他临床医生(平均正确回答率69%对49%)。只有36%(9/25)的儿科医生和8%(2/26)的其他临床医生意识到,在2003年12月1日前出生的孩子,如果其生父未与孩子母亲结婚,那么他需要法院命令或父母责任协议才能获得父母责任,从而能够代表其孩子给予同意。在关于有父母责任的人意见不一致的情况,或者有弗雷泽能力的16岁以下年轻人不想咨询父母的情况的测试中,非儿科临床医生不确定或回答错误。大多数临床医生不知道一名20岁重度学习困难男性的父母不能代表他同意手术,而且许多非儿科医生不清楚当孩子与养父母生活在一起时谁能给予同意。
为儿童治疗获取同意的临床医生需要增加关于谁能够给予知情同意的知识,以确保最佳(合法且安全)的医疗实践。