Gupta Gayatri, Singh Amol Nanak, Bansal Namita, Wander Gurpreet S
Student, NALSAR University of Law, Justice City, Shameerpet, Hyderabad, Telangana.
Student, Dayanand Medical College and Hospital, Ludhiana, Punjab.
J Assoc Physicians India. 2018 Oct;66(10):57-62.
Informed consent is an integral part of clinical practice. Improper informed consent can lead to mistrust between doctors and patients as well as medico-legal issues. Awareness and knowledge of various aspects of consent is essential in present day medical practice.
A paper and web-based survey was undertaken to evaluate knowledge about informed consent among doctors. A law and a medical student generated a list of questions based upon available case laws and legislations which were further validated by experts. 500 doctors undertook the survey and of these 457 completed the survey of 18 questions. Both univariate and multivariate models were used to analyze responses.
413 complete questionnaires were included in the analysis. The proportion of respondents furnishing correct responses varied between 49.6% and 93.7%. There were 9 questions for which, over 25% respondents provided inappropriate responses. The questions included those enquiring whether initial consent for diagnostic or therapeutic procedures could apply to extended procedures or surgery and who was capable of giving consent for different procedures. There were significant differences of knowledge between residents and consultants for few questions. The physicians fared worse than surgeons and anesthetists although the difference was not statistically significant.
Significant knowledge gaps were identified. There were deficiencies in providing correct response particularly in practical scenarios. There is a need to include knowledge about different aspects of informed consent in the medical curriculum.
知情同意是临床实践的一个组成部分。不恰当的知情同意会导致医患之间的不信任以及法律问题。在当今的医疗实践中，了解同意的各个方面的意识和知识至关重要。
开展了一项纸质和基于网络的调查，以评估医生对知情同意的了解情况。一名法律专业学生和一名医学专业学生根据现有判例法和法规生成了一系列问题，并由专家进一步验证。500名医生参与了调查，其中457人完成了包含18个问题的调查。采用单变量和多变量模型对回答进行分析。
413份完整问卷纳入分析。提供正确回答的受访者比例在49.6%至93.7%之间。有9个问题，超过25%的受访者给出了不恰当的回答。这些问题包括询问诊断或治疗程序的初始同意是否适用于扩展程序或手术，以及谁有能力对不同程序给予同意。在少数问题上，住院医生和会诊医生的知识存在显著差异。内科医生的表现比外科医生和麻醉医生差，尽管差异无统计学意义。
发现了显著的知识差距。在提供正确回答方面存在不足，尤其是在实际场景中。有必要在医学课程中纳入关于知情同意不同方面的知识。
