Circumcision and informed consent. Is more information always better?
This study observes that physicians routinely inform parents about a small minority of the medical complications and risks associated with elective circumcisions. When selecting which medical complications to mention to parents, physicians appeared to use a policy based on their subjective assessment of the frequency and seriousness of the complications' occurrence. Subsequent analyses revealed that the physicians' probability estimates were biased and their seriousness assessments were consistently less than those expressed by mothers of newborn sons. Replacing the physicians' policy of partial disclosure with a comprehensive disclosure of "unbiased" information of possible risks and complications had no effect on the mothers' decisions to have their sons circumcised but did generate numerous influences on the mothers' attitudes. Among the effects observed in mothers were a reduction in their confidence in the appropriateness of their decision and a dissatisfaction with their physician's behavior. The implications of these findings to informed consent are discussed, and a greater flexibility in providing informed consent is advocated.
Department of Management Sciences, University of Iowa, Iowa City 52242.
J J
JJ
Christensen-Szalanski
W T
WT
Boyce
H
H
Harrell
M M
MM
Gardner
D000328:Adult; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D002944:Circumcision, Male / Q000009:adverse effects*; D003625:Data Collection; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007258:Informed Consent; D007396:Internship and Residency; D008297:Male; D033282:Parental Consent; D010358:Patient Participation; D018570:Risk Assessment; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014342:Truth Disclosure