Sanwal A K, Kumar S, Sahni P, Nundy S
Department of Gastrointestinal Surgery, All India Institute of Medical Sciences, New Delhi, India.
J R Soc Med. 1996 Apr;89(4):196-8. doi: 10.1177/014107689608900406.
It is commonly believed that patients in India do not need to be told about their operations as they are unable to understand the complexities and forget the salient facts soon afterwards. Obtaining informed consent is therefore considered to be an unnecessary ritual. We studied 100 consecutive patients undergoing elective major abdominal operations and asked them 5 days after their operations to recall certain details about the procedure which had been explained to them preoperatively. Seventy per cent of the patients recalled the relevant data. The ability was the same in males and females (67% and 69%) but the older, less educated and poorer patients performed worse than the others. Ninety-eight per cent of the patients appreciated being given the information as it reduced their anxiety about the operation. Indian patients are able to comprehend and should be informed about the details of their operation. Particular care should be taken during explanation to the old, poor and illiterate. In these informed consent should be a continuous process rather than a single event and the information should also be given to a younger and more educated relative.
人们普遍认为,印度的患者无需被告知手术相关情况,因为他们无法理解其中的复杂性,而且术后很快就会忘记关键信息。因此,获得知情同意被视为一种不必要的程序。我们研究了100例连续接受择期腹部大手术的患者,并在术后5天询问他们能否回忆起术前向他们解释过的手术某些细节。70%的患者回忆起了相关信息。男性和女性的回忆能力相同(分别为67%和69%),但年龄较大、受教育程度较低和较贫困的患者表现不如其他患者。98%的患者表示,得到这些信息后焦虑感减轻,因此对获得这些信息表示感激。印度患者有能力理解,应该被告知手术的详细情况。向老年人、贫困者和文盲解释时应格外小心。在这些情况下,知情同意应该是一个持续的过程,而不是一次性事件,信息也应该告知年轻且受教育程度较高的亲属。