title: Informed consent and Italian physicians: change course or abandon ship--from formal authorization to a culture of sharing.
abstract: In Italy in recent years, an exponential increase in the frequency of medical malpractice claims relating to the issue of informed consent has substantially altered not only medical ethics, but medical practice as well. Total or partial lack of consent has become the cornerstone of many malpractice lawsuits, and continues to be one of the primary cudgels against defendant physicians in Italian courtrooms. Physicians have responded to the rising number of claims with an increase in 'defensive medicine' and a prevailing preoccupation with the purely formal aspects of consent. The result is a plethora of consent forms, believed to be a guarantee of 'informed consent', as well as a growing reliance on informed consent as a shield against judicial action brought by the patient. Physicians 'inform' patients without really sharing information, often delegating the task of communication to other professionals who are not doctors. Italian judges always condemn the physician when information to the patient has been inadequate, thus leading insurance companies to consider the lack of valid informed consent as the total responsibility of the physician and/or the hospital. It is necessary to change tack, to remove this idea of consent which permeates the defensive culture of medical practice. Italian physicians need to be trained, first of all, to become aware that information and consent are two distinct processes, albeit closely connected. Valid communication (in which there is information and consent) demands a higher level of professionalism from physicians.
authors.affiliation: University of Foggia, Foggia, Italy, emanuela_turillazzi@inwind.it.
authors.forename: Emanuela
authors.initials: E
authors.lastname: Turillazzi
authors.forename: Margherita
authors.initials: M
authors.lastname: Neri
mesh_terms: D001291:Attitude of Health Personnel; D003142:Communication; D003675:Defensive Medicine / Q000331:legislation & jurisprudence* / Q000639:trends; D004992:Ethics, Medical; D006801:Humans; D007258:Informed Consent / Q000941:ethics / Q000331:legislation & jurisprudence* / Q000592:standards; D007558:Italy; D008318:Malpractice / Q000331:legislation & jurisprudence* / Q000639:trends; D010817:Physician-Patient Relations; D010818:Practice Patterns, Physicians' / Q000331:legislation & jurisprudence* / Q000639:trends
references.citation: Am J Bioeth. 2012;12(3):22-9
references.pmid: 22416745
references.citation: Am J Orthod Dentofacial Orthop. 2011 Jan;139(1):133-5
references.pmid: 21195287
references.citation: Dig Liver Dis. 2013 Jun;45(6):469-73
references.pmid: 23402738
references.citation: Med Health Care Philos. 2014 May;17(2):301-11
references.pmid: 24343367
references.citation: Am J Bioeth. 2014;14(4):13-4
references.pmid: 24730481
references.citation: Ig Sanita Pubbl. 2014 Mar-Apr;70(2):235-46
references.pmid: 25008228
references.citation: BMC Med Ethics. 2014;15:57
references.pmid: 25023339
references.citation: Theor Med Bioeth. 2000;21(5):441-56
references.pmid: 11142441
references.citation: JAMA. 2003 Jan 1;289(1):93
references.pmid: 12503986
references.citation: J Med Ethics. 1997 Aug;23(4):239-44
references.pmid: 9279746
references.citation: Crit Rev Oncol Hematol. 2004 Dec;52(3):165-72
references.pmid: 15582784
references.citation: Clin Orthop Relat Res. 2009 Feb;467(2):434-42
references.pmid: 18985423
references.citation: Stud Health Technol Inform. 2009;148:206-21
references.pmid: 19745252
references.citation: Ann R Coll Surg Engl. 2010 Mar;92(2):93-100
references.pmid: 20353637
references.citation: Med Law. 2012 Jun;31(2):221-63
references.pmid: 22900412