What do obstetric patients consider as adequate disclosure during consent for anaesthesia for caesarean section?
Main Article Content
Abstract
Background: The need to respect the values and preferences of the patient (autonomy) is one of the pillars of informed consent. The physician must disclose information and treatment options that will enable the patient to consent to medical or surgical intervention. This study investigated the adequacy and understanding of the information (disclosure) given to parturients for elective Caesarean section during the preoperative assessment.
Methods: The attending anaesthetist administered a structured questionnaire to all women scheduled for elective Caesarean section on arrival at the Labour Ward Theatre. The interviewer-administered questionnaire assessed the socio-demographic characteristics, information on the anaesthetic options for Caesarean section, probable complications, risk-benefit analysis, and their understanding of the information provided by the trainee anaesthetist at the preoperative review. All women scheduled for emergency or urgent Caesarean section were excluded from the interview by the attending anaesthetist.
Results: A high proportion of the women were multiparous and had tertiary education. The benefit of being awake and hear the first cry from the newborn during the caesarean section was most attractive to the parturients. A good percentage of the women had the various techniques of anaesthesia explained to their understanding and had the opportunity for questioning with satisfactory responses. The commonly discussed complications were hypotension, shivering, headache, and possible failed regional technique. Most of the women had sufficient information to meet the requirements for adequate disclosure in the informed consent process for anaesthesia.
Conclusion: Most of the women had sufficient information to meet the requirements for adequate disclosure in the process of informed consent for anaesthesia.
Downloads
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
The journal grants the right to make small numbers of printed copies for their personal non-commercial use under Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported License.
References
1. Singer PA, Pellegrino ED, Siegler M. Clinical ethics revisited. BMC Medical Ethics 2001;2:E1.
2. Varkey B. Principles of clinical ethics and their application to practice. Med Princ Pract 2021;30(1):17-28.
3. Australian and New Zealand College of Anaesthetists. Guidelines on consent for anaesthesia or sedation. College Professional Document PS26. Melbourne: Australian and New Zealand College of Anaesthetists,2005.
4. Yentis SM, Hartle AJ, Barker IR, Barker P, Bogod DG, Clutton-Brock TH, et al. AAGBI: Consent for anaesthesia 2017: Association of Anaesthetists of Great Britain and Ireland. Anaesthesia 2017;72(1):93-105.
5. Betran AP, Ye J, Moller AB, Souza JP, Zhang J Trends and projections of caesarean section rates: global and regional estimates. BMJ Glob Health 2021;6(6):e005671.
6. Emanuel EJ, Emanuel LL. Four models of the physician-patient relationship. JAMA 1992;267(16):2221-2226.
7. Braun AR, Leslie K, Merry AF, Story D. What are we telling Our Patients? A Survey of risk disclosure for anaesthesia in Australia and New Zealand. Anaesth Intensive Care 2010;38(5):935-938.
8. Ekwere IT, Edomwonyi NP. Are Nigerian parturients afraid of information regarding the complications of spinal anaesthesia? Afr J Anaesth Intensive Care 2013;13(1):6-10.
9. Ogundiran TO, Adebamowo CA. Surgeons' opinions and practice of informed consent in Nigeria. J Med Ethics 2010;36(12):741-745.
10. Osime OC, Okojie O, Osadolor F, Mohammed S. Current practices and medico-legal aspects of pre-operative consent. East Afr Med J 2004;81(7):331-335.
11. Leffall LD Jr. Claude H. Organ, Jr. Honorary/Sandoz Nutrition Lectureship. Ethics in research and surgical practice. Am J Surg. 1997;174 (6):589-591.
12. Jamjoom AA, White S, Walton SM, Hardman JG, Moppett IK. Anaesthetists' and surgeons' attitudes towards informed consent in the UK: an observational study. BMC Med Ethics 2010;11:2.
13. Dawes PJ, Davison P. Informed consent: what do patients want to know? J R Soc Med 1994;87(3):149-152.
14. Narumi J, Miyazawa S, Miyata H, Suzuki A, Sugiura T, Oshiumi M, et al. Patients' understanding and opinion about informed consent for coronary angiography in a rural Japanese hospital. Intern Med 1998;37(1):18-20.
15. Gordon DR, Paci E. Disclosure practices and cultural narratives: understanding concealment and silence around cancer in Tuscany, Italy. Soc Sci Med 1997;44(10):1433-1452.
16. Pleat JM, Dunkin CS, Davies CE, Ripley RM, Tyler MP. Prospective survey of factors affecting risk discussion during consent in a surgical specialty. Br J Surg 2004;91(10):1377-1380.
17. Waisel DB, Truog RD. Informed consent. Anesthesiology 1997;87(4):968-978.
18. Gregory KD, Jackson S, Korst L, Fridman M. Cesarean versus vaginal delivery: whose risks? Whose benefits? Am J Perinatol 2012; 29(1):7-18.