INFORMED CONSENT - IS IT A MYTH

被引:69
作者
HERZ, DA
LOOMAN, JE
LEWIS, SK
STEWART, DH
BAGAN, M
机构
[1] MICHIGAN STATE UNIV,DIV NEUROSURG,GRAND RAPIDS,MI
[2] AQUINAS COLL,DEPT EDUC,GRAND RAPIDS,MI
基金
欧盟地平线“2020”;
关键词
INFORMED CONSENT; MALPRACTICE; PATIENT EDUCATION; RISK FACTORS; SPINAL FUSION;
D O I
10.1227/00006123-199203000-00028
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
The issue of informed consent at it relates to neurosurgical professional malpractice liability and litigation has been of concern for 20 years or more. The problem persists, and the subjects has been addressed by providing patient education with full disclosure regarding neurosurgical procedures. In the process of imparting informed consent, the authors studied the effectiveness of specific neurosurgical health care teaching. One hundred six persons undergoing anterior cervical fusion or lumbar laminectomy were instructed by a neurosurgeon and clinical nurse specialist with a master's degree in neurosurgery. Written testing was performed in each case immediately after a formal teaching session before surgery. Questions were simple and covered only four general topics: 1) diagnosis and surgical techniques; 2) operative risks; 3) postoperative care; and 4) goals and benefits relating to surgery. The mean score on testing immediate retention of information revealed a 43.5% overall performance rate. When patients were tested approximately 6 weeks later, the score dropped to 38.4%. This was statistically significant (chi(2), P < 0.05). The authors encourage the concept of patient education. The data in the current study, however, suggest that the reasonable and prudent neurosurgeon making a concerted effort at patient education, with the assistance of a professional educator, cannot necessarily expect accurate patient or family recall or comprehension. Fulfillment of the doctrine of informed consent by neurosurgeons may very well be mythical.
引用
收藏
页码:453 / 458
页数:6
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