Theoretical Background and Problems in Practicing the "Informed Consent"

ABSTRACT

OBJECTIVE: The informed consent, in literal sense, is a medicolegal process that requires full explanation and clear disclosure about the illness, and thorough comprehension and autonomous consent to the respective medical services of the competent recipient. The authors review the theoretical background of the informed consent and investigate pertinent problems encountered in medical practice. METHODS: We gathered 153 consecutive cases of written form of the informed consent regarding diagnosis and treatment from Mar 2001 to Jun 2002. The authors evaluate the completeness of the process by looking into the possible omitted components in whole cases and degree of recall for the explained risk by telephone questionnaire in 128 available cases. RESULTS: In a total 153 cohort, 21 emergency operation cases invariably showed structural deficiencies of free-ended discussion due to short of time. Thorough past history taking and physical examination was necessary to perform reoperation for the postoperative hematoma in 3 cases and solid intimate relationship was necessary to treat previously disclosed complication in 7 cases of invasive diagnostic and minimum operative procedures, respectively. Among the available 128 patients, only 33(25%) ones could recall the given risks addressed at the consent approximately 6 weeks later. CONCLUSION: The informed consent is a process that dictates the free dialogue between the patient and the physician, not a simple paper expressed in published characters. However, to enhance the effectiveness of the consent process, both free discussion and writing down contents are prerequisite.