Prospective survey of factors affecting risk discussion during consent in a surgical specialty

The British Journal of Surgery
J M PleatM P H Tyler

Abstract

The Department of Health in the UK has developed new consent guidance but without clear recommendations on how the incidence and severity of a given risk should influence its discussion during the process of obtaining informed consent. Plastic surgery is a litigation-prone specialty that offers a paradigm for assessing attitudes to consent. A questionnaire was sent to all surgeons at six plastic and reconstructive surgery units within the UK. It enquired what incidence of a relatively frequent minor severity risk such as wound infection, or an extremely rare but major risk such as stroke, would merit its discussion when obtaining informed consent for elective surgery. Sixty of 85 questionnaires were returned. For a minor risk, there was a consensus that an incidence threshold of 5 per cent or greater would necessitate its discussion. For a major risk, the modal threshold was 0.1 per cent, but there was a greater variability of response. There was a wide variation of opinion as to how frequently a major risk must occur before it is likely to be conveyed to a patient during the process of consent. The findings suggest that recent change in case law has yet to disseminate fully in one surgical specialty, with the potential for the...Continue Reading

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Citations

Apr 2, 2013·Hernia : the Journal of Hernias and Abdominal Wall Surgery·A M AikenC H Knowles
Oct 14, 2010·Journal of Medical Ethics·Temidayo O Ogundiran, Clement A Adebamowo
Jan 23, 2013·Patient Safety in Surgery·Wouter Kg LeclercqMarc R Scheltinga
Apr 8, 2010·World Journal of Surgery·Wouter K G LeclercqGert-Jan van der Wilt
Dec 4, 2014·International Journal of Pediatric Otorhinolaryngology·Emily PapsinPaul Hong

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