Doctors’ knowledge regarding decision-making capacity: A survey of anesthesiologists

2021 ◽  
pp. 147775092110635
Author(s):  
Alastair Moodley ◽  
Ames Dhai

Informed consent for anesthesia is an ethical and legal requirement. A patient must have adequate decision-making capacity (DMC) as a prerequisite to informed consent. In determining whether a patient has sufficient DMC, anesthesiologists must draw on their knowledge of DMC. Knowledge gaps regarding DMC may result in incorrect assessments of patients’ capacity. This could translate to an informed consent process that is ethically and legally unsound. This study examined the DMC-related knowledge of anesthesiologists in a group of four university-affiliated hospitals. The findings suggest that anesthesiologists have several areas of knowledge deficiency regarding DMC and DMC assessment. These findings could inform the development of undergraduate and postgraduate curricula.

2008 ◽  
Vol 18 (4) ◽  
pp. 284-289 ◽  
Author(s):  
Anita K. Sites ◽  
Jason R. Freeman ◽  
Michael R. Harper ◽  
David B. Waters ◽  
Timothy L. Pruett

Education is critical in decision making and the informed consent process in prospective living donors. Little has been written about how and what living donors should be taught. This article describes a multidisciplinary program for living donor education at the University of Virginia. The goals of the program are to impart information needed for prospective donors to make an informed decision and to independently evaluate donors' medical and psychosocial suitability. A partnership between the transplant department and an independent donor advocacy team establishes an environment conducive to education. By embracing independence, transparency, partnership, and advocacy, our program permits bidirectional education. This partnership facilitates unbiased understanding and appreciation of this education and considers each individual's unique circumstances when making informed decisions. Likewise, prospective donors educate the team about their circumstances, which helps the team safeguard the prospective donor and may enhance the safety of prospective donors and the perceived integrity of living organ donation.


2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 9072-9072
Author(s):  
S. Hitchcock-Bryan ◽  
B. Hoffner ◽  
S. Joffe ◽  
M. Powell ◽  
C. Parker ◽  
...  

9072 Background: In an effort to improve the informed consent process for subjects considering participation in a clinical trial, we created an educational video: “Entering a Clinical Trial: Is it Right for You?” In this randomized study, we assessed the effect of the video on patients’ understanding and perceptions of clinical trials. We also assessed patient satisfaction with the video and how the video impacted decision-making and patient-provider communication. Methods: We recruited 90 adults considering cancer clinical trials of whom 77 participated. After discussing the trial with the physician and reading the trial consent form, patients were randomized to receive (n=38) or not receive (n=39) the study video. Using a validated questionnaire, we interviewed subjects to assess objective understanding of the trial, our primary endpoint, and self-reported understanding of clinical trials. All subjects completed a second interview assessing secondary endpoints, including patient-provider communication, satisfaction with video, and decision-making. We used linear regression (two-sided tests) to conduct the primary analysis and the Wilcoxon rank-sum test and descriptive statistics to analyze the secondary aims. Results: Neither objective nor self-reported understanding of clinical trials differed between the two groups (Mean 86.5 vs. 87, p=0.75). 85% (61/72) indicated the video was an important source of information about clinical trials; 89% of those who watched the video with their family/friends (n=37) said the video helped loved ones better understand clinical trials; 73% indicated it helped their family accept their decision about participation. 81% (58/72) felt better prepared to discuss the trial with their physician after watching the video. Of those who found the video helpful with decision- making, 80% (21/26) were considering a trial for the first time compared with 19% (5/26) veterans who had previously participated in a clinical trial. Conclusions: The video did not measurably improve subjects’ understanding of their clinical trials. However, subjects reported that the video was an important source of information, helped them educate their families, and enhanced patient-provider communication. No significant financial relationships to disclose.


2019 ◽  
Vol 32 (1) ◽  
pp. 340-347
Author(s):  
Amanda L. Porter ◽  
James Ebot ◽  
Karen Lane ◽  
Lesia H. Mooney ◽  
Amy M. Lannen ◽  
...  

Author(s):  
Mary Alice Fisher

Chapter 6 walks therapists through Step 3, and covers how to obtain truly informed consent before disclosing confidential information voluntarily. It emphasizes that ‘confidential’ is a reminder that every disclosure of patient information constitutes an exception to the rule of confidentiality, and how therapists are often tempted (or urged by others) to create their own ‘personal exceptions’, and this chapter is therefore a reminder that, ethically speaking, confidentiality is still the rule. It also examines how, in the absence of a legal requirement to disclose, information about a patient should ordinarily remain confidential, and therapists should not disclose it without first obtaining the patient’s consent, either as part of the informed consent process at intake or in preparation for a patient-specific disclosure.


2016 ◽  
Vol 29 (2-3) ◽  
pp. 245-253 ◽  
Author(s):  
Rebecca A. Ferrer ◽  
Jennifer Tehan Stanley ◽  
Kaitlin Graff ◽  
William M. P. Klein ◽  
Nina Goodman ◽  
...  

2019 ◽  
Vol 4 (3) ◽  
pp. 57-66 ◽  
Author(s):  
Astrid Pratidina Susilo ◽  
◽  
Brahmaputra Marjadi ◽  
Jan van Dalen ◽  
Albert Scherpbier ◽  
...  

2020 ◽  
Vol 42 (5_suppl) ◽  
pp. 16S-22S
Author(s):  
Guru S Gowda ◽  
Arun Enara ◽  
Furkhan Ali ◽  
Mahesh R Gowda ◽  
Chethan Basavarajappa ◽  
...  

Consent is an essential and important medico-legal prerequisite for a patient’s treatment. This necessitates the service provider to participate in the informed consent process and discuss the risk-benefit of the proposed treatment, the best available treatment, engage in shared decision-making process, opportunity to convey their view and thereby limit chances of legal liability for all parties. The clinician should have ample knowledge and skill pertaining to the informed consent process and also have adequate understanding of medical ethics and law. This article provides an overview on informed consent pertaining to telepsychiatric services in India.


Author(s):  
Laura A. Siminoff ◽  
Maria D. Thomson

Our knowledge and understanding of bioethics is informed by cancer communication research, particularly around the informed consent process and participation in clinical trials. This chapter provides an overview of several ethical theories used to guide bioethics, including principlism, casuistry, and virtue ethics. With these in mind, the informed consent process and the importance of quality communication is described. Despite many patients preferring a style of communication that is more participatory in nature, physicians still struggle with how much and what kind of information to share regarding clinical trials. In the context of palliative care, surrogate decision-making adds an additional layer of complexity to this process. Further, many patients still endorse the ‘therapeutic misconception’, meaning they believe experimental treatments are superior to standard treatments. The communication models of paternalism, the fully informed model, and shared decision-making are described, with the goal to provide patients with clear, unbiased information to inform decision-making.


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