The process of informed consent for urgent abdominal surgery.
OBJECTIVE
To assess perceptions of the informed consent process in patients undergoing urgent abdominal surgery.


METHODS
A prospective observational study was carried out using structured questionnaire-based interviews. Patients who had undergone urgent abdominal surgery were interviewed in the postoperative period to ascertain their perceptions of the informed consent process. Replies were compared to responses obtained from a control group undergoing elective surgery, to identify factors common to the surgical process and those specific to urgent surgery. Patients' perceptions of received information were also compared to the information perceived to have been provided by the consent obtainers.


METHODS
Gastrointestinal surgical service of a university teaching hospital.


METHODS
Seventy-four consecutive patients undergoing urgent abdominal surgery and 80 control patients undergoing elective surgery.


METHODS
Principal outcome measures were patients perceptions of factors interfering with the ability to give informed consent, assessment of the quality of informed consent and the degree of discussion of the expected outcomes.


RESULTS
Forty-nine of the seventy-four (66%) patients undergoing urgent surgery perceived that pain did not affect their ability to give informed consent. Twenty-seven reported an adverse effect of analgesia on the ability to give informed consent. Only 22% of patients undergoing urgent surgery perceived that there had been any discussion of potential side effects and complications of surgery.


CONCLUSIONS
The majority of patients in this series with acute intra-abdominal surgical conditions perceive that they retain the ability to give informed consent for surgery. There is a need for improved discussion of therapeutic options and likely outcomes.
Kay
R
R
University Department of Surgery, Royal Infirmary of Edinburgh.
Siriwardena
A K
AK
D000006:Abdomen, Acute / Q000150:complications / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000698:Analgesia / Q000009:adverse effects / Q000523:psychology; D013505:Digestive System Surgical Procedures; D004992:Ethics, Medical; D005260:Female; D006801:Humans; D007258:Informed Consent; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000188:drug therapy / Q000523:psychology; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D011184:Postoperative Period; D011446:Prospective Studies; D012606:Scotland; D011795:Surveys and Questionnaires