Open AccessInformed consent in cardiac surgery - current institutional practice and legislation
Author(s) -
Milica Karadzic-Kocica,
Hristina Ugrinovic,
Miloš Grujić,
Dejan Lazović,
Filip Vucicevic,
Goran Panić,
Mladen J. Kočica
Publication year - 2022
Publication title -
vojnosanitetski pregled
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.123
H-Index - 19
eISSN - 2406-0720
pISSN - 0042-8450
DOI - 10.2298/vsp200115029k
Subject(s) - legislation , medicine , informed consent , cardiac surgery , disease , family medicine , surgery , general surgery , law , alternative medicine , political science , pathology
Background / Aim: To determine the current state of the institutional informed consent policy before elective cardiac surgical procedures in light of actual national legislation. Methods: An anonymous, voluntary survey was conducted among 200 consecutive patients, at the Clinic for Cardiac Surgery, UC Clinical Centre of Serbia, from September to December 2019, after having signed an official institutional consent form. A targeted questionnaire was created to determine the quantity and quality of patient?s information about general and the most important aspects of cardiac surgical care. Results: The mean age of respondents was 66.2 years, with male predominance (68.0%), homogenous ethnicity, and low-to-middle (84.0%) education levels. A significant percentage had no information on the type of surgery (16.0%), extracorporeal circulation (46.0%), anaesthesia (56.0%) and transfusion (51.5%). Of those having some information, 7.0%-20.0% graded them sufficient. The worst situation was recorded concerning risks of disease and surgical treatment, where 88.0% of patients had no information and almost 90.0% having some information, graded them non-sufficient. Surprisingly, 81.5% of patients have signed the consent form without any prior discussion with the operating surgeon. For 56.0% of patients. the information in the actual consent form was clear and sufficient. While 85.5% of patients claimed the importance, the others (14.5%) were not interested to know the most relevant information about their disease and surgery. Conclusion: The results unambiguously indicate an unacceptably low level of our patients? information about the cardiac surgical procedure, extracorporeal circulation, anesthesia, transfusion, and estimated risk. The majority of them (85.5%) comprehend the importance and expect timely and adequate information. An extremely high percentage (81.5%) of patients had no chance to discuss the procedure with the operating surgeon. Both surgical indifference and insufficient knowledge of professional, ethical, and legal importance, are the most important reasons for actual informed consent policy in cardiac surgery.