Biersack M G, Volmer L L, Geißler C, Fromme J, Fröhlich S, Pietzner K, Sehouli J, Beck M H
Young Academy of Gynecologic Oncology (JAGO), Nord-Ostdeutsche Gesellschaft für Gynäkologische Onkologie, 13359, Berlin, Germany.
Department of Women's Health, Klinikum Fürstenfeldbruck, 82256, Fürstenfeldbruck, Germany.
Arch Gynecol Obstet. 2025 Feb;311(2):451-457. doi: 10.1007/s00404-024-07776-9. Epub 2024 Nov 1.
Informed consent is a quintessential element of contemporary medicine, reflecting the fundamental right of patients to participate in decision-making regarding their health. Despite its critical importance, there is a lack of data on real-world practices regarding patient informed consent in the context of modern, high-pressure medical environments.
We conducted a multinational multicentric survey from February 24, 2022, to September 14, 2022, investigating the practices and challenges surrounding informed consent in hospitals across Germany, Austria, and Switzerland with the use of a specifically developed questionnaire.
Drawing on over 200 responses from gynecologists, the survey shows a critical need for structured training in conducting informed consent discussions with over 80% of participants expressing interest in courses addressing this aspect. Notably, a considerable portion of the physicians (59.9%) reported conducting discussions on procedures they had never personally witnessed. Significant disparities between types of hospitals and professional groups were observed in the frequency of informed consent discussions, with limitations arising from factors such as time constraints, language barriers, and insufficient resources for patient education. Moreover, the psychological burden experienced by physicians after informed-consent discussions underscores the need for systemic changes to alleviate concerns regarding patient safety, legal repercussions, and patient satisfaction.
This study serves as a call to action, emphasizing the need of enhancing resources and support for medical professionals to uphold the principles of empathic and comprehensive patient information and shared decision-making.
DRKS00028295, 25.07.2024.
知情同意是当代医学的一个基本要素，反映了患者参与自身健康决策的基本权利。尽管其至关重要，但在现代高压医疗环境下，关于患者知情同意的实际做法缺乏数据。
我们于2022年2月24日至2022年9月14日进行了一项多国多中心调查，使用专门编制的问卷，调查德国、奥地利和瑞士各医院围绕知情同意的做法和挑战。
基于妇科医生的200多份回复，调查显示迫切需要进行结构化培训以开展知情同意讨论，超过80%的参与者表示对涉及这方面的课程感兴趣。值得注意的是，相当一部分医生（59.9%）报告称就他们从未亲自目睹过的手术进行讨论。在知情同意讨论的频率方面，不同类型医院和专业群体之间存在显著差异，时间限制、语言障碍以及患者教育资源不足等因素导致了一些限制。此外，医生在知情同意讨论后所经历的心理负担凸显了进行系统性变革以减轻对患者安全、法律后果和患者满意度担忧的必要性。
本研究发出行动呼吁，强调需要加强对医疗专业人员的资源和支持，以秉持共情和全面的患者信息以及共同决策的原则。
DRKS00028295，2024年7月25日。
