article · BMC Medical Ethics
Informed consent practices in surgical care remain inadequate across university teaching hospitals in low-resource settings. An evaluation conducted across three teaching hospitals in Uganda gathered data from 132 completed surgical staff questionnaires, 20 in-depth interviews with surgeons, and a review of 384 patient record files. The findings indicate that only 48.8 percent of surveyed practitioners obtained consent every time surgery was performed, whilst 51.2 percent did not do so consistently. Furthermore, consent was frequently gathered at admission or by nursing staff rather than by the operating surgeon. Hospital consent forms were often inadequate and routinely signed upon patient admission prior to establishing a definitive diagnosis. Consequently, the administration and documentation of surgical informed consent fall short of established standards in these clinical environments.
Informed consent is a fundamental standard of medical care that protects patient autonomy and safety prior to invasive procedures. Identifying deficiencies in how consent is collected and recorded highlights critical procedural vulnerabilities within hospital workflows. Addressing these gaps is vital for ensuring that surgical patients fully understand and agree to their treatment plans before operations are undertaken.
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BACKGROUND: Informed consent in medical practice is essential and a global standard that should be sought at all the times doctors interact with patients. Its intensity would vary depending on the invasiveness and risks associated with the anticipated treatment. To our knowledge there has not been any systematic review of consent practices to document best practices and identify areas that need improvement in our setting. The objective of the study was to evaluate the informed consent practices of surgeons at University teaching Hospitals in a low resource setting. METHODS: A cross-sectional study conducted at three university teaching hospitals in Uganda. Self-guided questionnaires were left at a central location in each of the surgical departments after verbally communicating to the surgeons of the intention of the study. Filled questionnaires were returned at the same location by the respondents for collection by the research team. In addition, 20 in-depth interviews were held with surgeons and a review of 384 patients' record files for informed consent documentation was done. RESULTS: A total of 132 (62.1%) out of 214 questionnaires were completed and returned. Respondents were intern doctors, residents and specialists from General surgery, Orthopedic surgery, Ear, Nose and Throat, Ophthalmology, Dentistry, Obstetrics and Gynaecology departments. The average working experience of respondents was 4.8 years (SD 4.454, range 0-39 years). 48.8% of the respondents said they obtained consent all the time surgery is done while 51.2% did not obtain consent all the time. Many of the respondents indicated that informed consent was not obtained by the surgeon who operated the patient but was obtained either at admission or by nurses in the surgical units. The consent forms used in the hospitals were found to be inadequate and many times signed at admission before diagnosing the patient's disease. CONCLUSIONS: Informed consent administration and documentation for surgical health care is still inadequate at University teaching hospitals in Uganda.
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DOI: 10.1186/1472-6939-15-40
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