Lack of informed consent for surgical procedures by elderly patients with inability to consent: a retrospective chart review from an academic medical center in Norway
| العنوان: | Lack of informed consent for surgical procedures by elderly patients with inability to consent: a retrospective chart review from an academic medical center in Norway |
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| المؤلفون: | Reidun Førde, Reidar Pedersen, Vegard Dahl, Jørgen Dahlberg |
| المصدر: | Patient Safety in Surgery, Vol 13, Iss 1, Pp 1-6 (2019) Patient Safety in Surgery |
| بيانات النشر: | BMC, 2019. |
| سنة النشر: | 2019 |
| مصطلحات موضوعية: | medicine.medical_specialty, media_common.quotation_subject, Coercion, Legal requirements, lcsh:Surgery, Norwegian, Competent, Competence (law), 03 medical and health sciences, 0302 clinical medicine, Documentation, Informed consent, Competence, Health care, medicine, Orthopedics and Sports Medicine, 030212 general & internal medicine, Autonomy, media_common, business.industry, Medical record, Research, 030208 emergency & critical care medicine, lcsh:RD1-811, medicine.disease, language.human_language, humanities, Surgery, Anesthesiology and Pain Medicine, language, Health law, Medical emergency, business, Patient rights |
| الوصف: | Background Respect for patient autonomy and the requirement of informed consent is an essential basic patient right. It is constituted through international conventions and implemented in health law in Norway and most other countries. Healthcare without informed consent is only allowed under specific exceptions, which requires a record in the patient charts. In this study, we investigated how surgeons recorded decisions in situations where the elderly patient’s ability to provide a valid informed consent was questionable or clearly missing. Method We investigated all medical records of patients admitted to surgical departments in a Norwegian large academic emergency hospital over a period of 38 days (approximately 5000 patients). We selected records of patients above the age of 70 (570 patients) and searched through these 570 medical records for any noted clear indications of inability to consent such as “do not understand”, “confused” etc. (102 patients). We read through all the medical records on these 102 patients noting any recordings on lack of informed consent, any recordings on reasoning and process hereto. We also took note whether there were clear indications on the use of coercion. Results None of the 102 included patients´ charts contained legally valid recorded assessments (for example related to the patients´ competence to consent) when patients without the ability to consent were admitted and provided healthcare. Some charts contained records that the patient resisted treatment, thus indicating treatment with coercion. In these situations, we did not find any documentation related to legal requirements that regulate the use of coercion. Discussion and conclusion We found a substantial lack of compliance with the legal requirements that apply when obtaining valid informed consent. There are many possible reasons for this: Lack of knowledge of the legal requirements, disagreement about the rules, or that it is simply not possible to comply with the extensive formal and material legal requirements in clinical practice. The results do not point out whether the appropriate measures are amending the law, educating and requiring more compliance from surgeons, or both. |
| اللغة: | English |
| تدمد: | 1754-9493 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::e187dad2d6e868866087cafd1ad7a560 http://link.springer.com/article/10.1186/s13037-019-0205-5 |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi.dedup.....e187dad2d6e868866087cafd1ad7a560 |
| قاعدة البيانات: | OpenAIRE |
Find this article in full text from Springer Verlag. | تدمد: | 17549493 |
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