From understanding to agreement: The current state of informed consent in Nigerian endoscopic practice

Abstract

BACKGROUND: Informed consent is a cornerstone of ethical endoscopic practice, ensuring that patients understand and agree to the procedures that they undergo. Despite its importance, studies suggest that variations in consent practices persist. There is also a paucity of information on endoscopic consent practices in sub-Saharan Africa. AIM: To investigate current practices around consent taking among endoscopists in Nigeria. METHODS: This cross-sectional survey was conducted from August to September 2024 among endoscopists practicing in Nigeria. The participants completed a 32-part self-administered online questionnaire that documented the experiences of endoscopists concerning consent taking in endoscopy practice. These included the location of practice, awareness of legislation concerning informed consent in Nigeria, patient autonomy, various procedural risks discussed with patients, and challenges faced. At the end of the survey, the responses were analyzed using tables, pie charts, and figures. RESULTS: A total of 68 participants responded to the questionnaire. The mean age of the participants was 45.2 ± 6.6 years. There were 26 (38.2%) females and 42 (61.8%) males. Participants practicing in the northern part of the country comprised 41.1% (30) of the participants, while those practicing in southern Nigeria were 58.9% (38). Only 49.3% were aware of legislation about informed consent in Nigeria. The majority of the study participants (69.1%) gave the patients a few minutes to digest information before the procedure. A variety of risks were reported to be discussed, with abdominal discomfort being the most common (83.8%). The challenge to adequate consent was inadequate time for consent taking due to high patient burden (60.6%). CONCLUSION: Consent taking for endoscopy in Nigeria is not ideal; many healthcare workers only gave patients a few minutes to understand information about the procedure. To address this, training workshops and online webinars should be organized to train medical staff on how to do it properly. This will help improve patient care, ensure safety, and lead to better health results for patients.