Department of Urology, Beaumont Hospital, Beaumont, Dublin 9, Republic of Ireland.
Department of Urology, Connolly Hospital, Blanchardstown, Dublin 15, Republic of Ireland.
Ir J Med Sci. 2024 Apr;193(2):1079-1083. doi: 10.1007/s11845-023-03444-0. Epub 2023 Aug 7.
Informed consent is a continuous process of communication with the patient and not merely the signing of a form. The Irish Medical Council's Guide to Good Practice and Ethics state that no part of the consent process should be delegated to an intern unless the procedure is a minor with which the intern is very familiar and all relevant information has first been explained to the intern.
We aimed to evaluate whether practices regarding interns and consent had changed in the past five years.
An anonymous Google Forms survey was distributed to interns from all intern networks between 24-August and 26-November 2021.
Of 854 interns, there were 147(17.2%) survey responses. 129(87.8%) participants had consented for a procedure. 111(86%) responded that they had consented for procedures that they had not witnessed before. 92(71.3%) reported that their medical supervisor did not explain procedures to them prior to obtaining consent. 128(99.2%) of interns were not usually observed by a more senior doctor when obtaining consent. 116(89.9%) were expected to obtain consent from patients on a regular basis, with 78(60.5%) feeling pressured into doing so on at least one occasion. Results were largely unchanged compared to when the same survey was circulated in 2016.
Interns remain routinely involved in the consent process without adequate training or supervision. This is unfair on our most junior doctors and on patients. Steps must be taken to ensure the IMC guidance is adhered to and this deficiency must be highlighted to Senior Clinicians.
知情同意是一个与患者持续沟通的过程，而不仅仅是签署表格。爱尔兰医学委员会的良好实践和伦理指南指出，除非程序是实习生非常熟悉的轻微程序，并且已经向实习生解释了所有相关信息，否则不应将同意过程的任何部分委托给实习生。
我们旨在评估过去五年中关于实习生和同意书的做法是否发生了变化。
我们向 2021 年 8 月 24 日至 11 月 26 日期间来自所有实习网络的实习生分发了匿名谷歌表单调查。
在 854 名实习生中，有 147 人（17.2%）做出了回应。129 名（87.8%）参与者同意进行某项程序。111 名（86%）表示他们同意进行他们之前没有见证过的程序。92 名（71.3%）报告说，他们的医疗主管在获得同意之前没有向他们解释程序。128 名（99.2%）实习生在获得同意时通常没有由更高级别的医生观察。116 名（89.9%）实习生被期望定期从患者那里获得同意，其中 78 名（60.5%）至少有一次感到被迫这样做。与 2016 年发布的相同调查相比，结果基本没有变化。
实习生仍然经常参与同意过程，而没有接受足够的培训或监督。这对我们最年轻的医生和患者都是不公平的。必须采取措施确保遵守 IMC 指南，并且必须向高级临床医生强调这一缺陷。
