The need for improved training of surgeons in documentation of informed consent

Author(s):  
Nader Henry ◽  
Haneen Abed ◽  
David Wallace
OTO Open ◽  
2020 ◽  
Vol 4 (2) ◽  
pp. 2473974X2092114 ◽  
Author(s):  
Megan L. Swonke ◽  
Nasim Shakibai ◽  
Mohamad R. Chaaban

Objectives This study aims to examine litigation trends with thyroidectomies in the United States from 1984 to 2018. Methods We used the Westlaw legal database to collect data on the defendant, plaintiff, case demographics, alleged reasons for malpractice, additional complications, and case outcomes. Results The most common reason for litigation was vocal cord paralysis (51%, n = 28), with the majority ruling in favor of the defendant (64%, P = .042). Of those, 43% of cases (n = 12) were due to unilateral recurrent laryngeal nerve (RLN) injury, and 39% (n = 11) were due to bilateral RLN injury. Of the claims due to vocal cord paralysis that resulted in indemnity payment (36%), the majority included additional damages, such as lack of informed consent (30%) or subsequent damages from permanent tracheostomy (40%), which is usually a result of bilateral nerve paralysis. Conclusion RLN injury was the most common complication leading to trial, with most cases ruling in favor of the defense. However, most verdicts that favored the plaintiff or those that settled were due to subsequent damages from bilateral nerve paralysis, such as permanent tracheostomy. We encourage surgeons to consider a staged procedure in high-risk cases or cases with signal loss. There needs to be a bigger emphasis on informed consent in the training of surgeons. Surgeons should educate patients at high risk on potential surgical complications that may drastically affect their quality of life.


2001 ◽  
Vol 6 (2) ◽  
pp. 6-8
Author(s):  
Christopher R. Brigham

Abstract The AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Fifth Edition, explains that independent medical evaluations (IMEs) are not the same as impairment evaluations, and the evaluation must be designed to provide the data to answer the questions asked by the requesting client. This article continues discussions from the September/October issue of The Guides Newsletter and examines what occurs after the examinee arrives in the physician's office. First are orientation and obtaining informed consent, and the examinee must understand that there is no patient–physician relationship and the physician will not provide treatment bur rather will send a report to the client who requested the IME. Many physicians ask the examinee to complete a questionnaire and a series of pain inventories before the interview. Typical elements of a complete history are shown in a table. An equally detailed physical examination follows a meticulous history, and standardized forms for reporting these findings are useful. Pain and functional status inventories may supplement the evaluation, and the examining physician examines radiographic and diagnostic studies. The physician informs the interviewee when the evaluation is complete and, without discussing the findings, asks the examinee to complete a satisfaction survey and reviews the latter to identify and rectify any issues before the examinee leaves. A future article will discuss high-quality IME reports.


2006 ◽  
Vol 5 (12) ◽  
pp. 62
Author(s):  
ELIZABETH MECHCATIE
Keyword(s):  

Author(s):  
Deborah Bowman ◽  
John Spicer ◽  
Rehana Iqbal
Keyword(s):  

Pflege ◽  
2001 ◽  
Vol 14 (1) ◽  
pp. 29-37 ◽  
Author(s):  
Anja Schopp ◽  
Theo Dassen ◽  
Maritta Välimäki ◽  
Helena Leino-Kilpi ◽  
Gerd Bansemir ◽  
...  

Ziel dieser Untersuchung war die Autonomie, Privatheit und die Umsetzung des Prinzips der «informierten Zustimmung» aus der Perspektive des institutionell zu betreuenden, älteren Menschen zu beschreiben. Die Untersuchung ist ein Teil des durch die EU-Kommission unterstützten BIOMED 2 Projektes «Patient’s autonomy and privacy in nursing interventions»1. Interviewdaten (n = 95) wurden in deutschen Kliniken der Geriatrie und Pflegeheimen gesammelt. Ergebnisse zeigten, dass die Teilnehmer in geringem Maß selbstbestimmte Entscheidungen treffen konnten. Das Prinzip der «informierten Zustimmung» wurde wenig umgesetzt. Ihre Privatheit sahen die Teilnehmer in Mehrbettzimmern sowie in Situationen des Ankleidens und bei der Verrichtung der Ausscheidungen nicht respektiert. Es ist anzunehmen, dass ältere Menschen wegen Informationsdefiziten, durch ihren Hilfsbedarf und durch die festgelegten Organisationsstrukturen der Pflegeeinrichtungen eine passive Krankenrolle übernehmen. Es wäre denkbar, dass die Autonomie der älteren Menschen gefördert werden könnte, wenn die Pflegekräfte sie in der Rolle des Fürsprechers bei selbstbestimmten Entscheidungen unterstützen würden. Bei den pflegerischen Interventionen würde die Umsetzung des Prinzips der «informierten Zustimmung» sowohl die Autonomie als auch die Respektierung der Privatheit fördern. Es ist außerdem anzunehmen, dass durch Flexibilisierung der Organisationsstrukturen der Pflegeeinrichtungen die Autonomie und Lebensqualität der älteren Menschen gefördert werden könnte.


1985 ◽  
Vol 40 (9) ◽  
pp. 1062-1063 ◽  
Author(s):  
Joseph Graca
Keyword(s):  

1990 ◽  
Vol 35 (1) ◽  
pp. 38-39
Author(s):  
Stephen L. Golding

1979 ◽  
Author(s):  
C. Michael Levy ◽  
Yvonne Brackbill
Keyword(s):  

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