Informed consent--a survey of doctors' practices in South Africa.
OBJECTIVE
To examine doctors' practices with regard to informed consent.


METHODS
Cross-sectional, descriptive survey.


METHODS
All full-time consultants and registrars in the Departments of Medicine, Obstetrics and Gynaecology, Paediatrics and Child Health, Paediatric Surgery and Surgery at the University of Cape Town were included. The overall response rate was 63% (160/254).


METHODS
Data were collected by means of self-administered, semi-structured questionnaires.


RESULTS
Most doctors (79%) felt it was their responsibility to ensure that patients and parents were fully informed about diagnostic and therapeutic interventions. Many (62%) supported a patient-centred standard for determining the type and amount of information to disclose. Doctors disclose most of the legally required information except for information about alternative forms of treatment and remote serious risks. They almost never provide information on medical costs. The most common reasons for not obtaining informed consent were the doctors' tendency to 'tell' patients/parents what they intend doing and their belief that patients/parents expect doctors to know what is medically best for them. Language, inadequate communication skills and lack of time were, surprisingly, seldom viewed as obstacles to the obtaining of informed consent. Findings were independent of discipline (medical or surgical) and doctors' status (consultant or registrar). Doctors who treat children were significantly less likely to obtain consent for certain interventions.


CONCLUSIONS
Doctors meet many, but not all, of the legal requirements for informed consent. The findings question whether informed consent as envisioned by the law exists in reality. Cross-cultural research is needed to clarify patients' and parents' expectations of informed consent.
Henley
L
L
Department of Paediatrics and Child Health, University of Cape Town.
Benatar
S R
SR
Robertson
B A
BA
Ensink
K
K
D032882:Comprehension; D003430:Cross-Sectional Studies; D030881:Disclosure; D004992:Ethics, Medical; D006801:Humans; D007258:Informed Consent; D033282:Parental Consent; D026706:Paternalism; D010818:Practice Patterns, Physicians'; D018570:Risk Assessment; D012945:Social Values; D013019:South Africa; D011795:Surveys and Questionnaires; D014342:Truth Disclosure