Informed Consents or Consent of Information? Assessing Quality of Informed Consents for Scheduled Cesarean Section

Background
Informed consents of patients undergoing procedures are important not only for ethical and legal reasons but also for the quality of care. Patients’ understanding allows for better cooperation, improves results and satisfaction and helps prevent errors. Providers must ensure that the patient understands the nature of their condition, the risks and benefits of the procedure, the alternatives, and agrees voluntarily. Although consents are a well-established practice, it often fails to meet its purpose. Providers must realize that signing a consent form is not equivalent to receiving informed consent.

Methods
A cross sectional survey of patients admitted for scheduled cesarean section. The anonymous questionnaires were administered within 30 minutes to 48 hours of having the consent explained. The questions focused on patient’s recall of information about the explanation of the procedure, risks and alternatives, preferences about the decision process and overall satisfaction with the way the consent was obtained.

Results
Only 9% of the patients didn’t receive explanations about risks but 42% didn’t have discussions of alternative options. Most patients (70%) weren’t asked to repeat the explanation. Expectations about decision varied, with 65% favoring shared decision and nearly 26% preferring autonomous decision. Satisfaction was rated as good or very good by 94% of patients.

Conclusions
In conclusion, most patients do not remember receiving explanations about alternatives for procedures nor are they asked to repeat explanations. We recommend that the quality of consents be regularly assessed to ensure informed consent is being obtained.