Stepping Up Informed Consent: Navigating Foot and Ankle Orthopedics.

Suraj Jain, Zachary Chanmin, Janice Havasy, Benjamin Hershfeld, Brandon Klein, Randy M Cohn, Adam D Bitterman
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Abstract

Orthopaedic foot and ankle surgeons have an ethical obligation to obtain proper informed consent, ensuring that their patients are thoroughly educated about their diagnosis, risks, benefits, and alternatives of all possible treatment options. This study explores several critical aspects of the informed consent process in foot and ankle orthopedics, including: (1) its current state; (2) barriers that hinder the acquisition of adequate informed consent; and (3) potential solutions based on these identified barriers. The current literature suggests effective approaches to improve the quality of informed consent include using patient-appropriate language, standardized education materials, extended physician-patient visit times, and translation assistance. Utilizing plain language and supplemental materials, such as animated videos and standardized reading materials, enhance patient comprehension and decision-making. Integrating these methods with personalized patient-surgeon discussions results in optimal informed consent quality and patient satisfaction. Additionally, extended visit times, ideally 15 to 30 minutes, improve understanding, while interpreter services ensure clear communication for nonnative speakers. The findings of this study reveal significant deficiencies in the current informed consent process for foot and ankle orthopaedic surgery, which compromise patient autonomy. Implementing solutions to improve the quality of informed consent is necessary to protect patient autonomy and protect surgeons from litigation.Level of Evidence: IV.

加强知情同意:引导足部和踝关节矫形手术。
足部和踝关节矫形外科医生有道德义务获得适当的知情同意,确保他们的病人完全了解他们的诊断、风险、益处和所有可能的治疗方案。本研究探讨了足部和踝关节矫形术中知情同意过程的几个关键方面,包括:(1)其现状;(2)阻碍获得充分知情同意的障碍;(3)基于这些确定的障碍的潜在解决方案。目前的文献表明,提高知情同意质量的有效方法包括使用适合患者的语言、标准化的教育材料、延长医患就诊时间和翻译协助。利用通俗易懂的语言和辅助材料,如动画视频和标准化阅读材料,提高患者的理解和决策能力。将这些方法与个性化的患者-外科医生讨论相结合,可获得最佳的知情同意质量和患者满意度。此外,延长访问时间,最好是15到30分钟,可以提高理解,而翻译服务可以确保非母语人士的清晰沟通。本研究的发现揭示了目前足部和踝关节矫形手术知情同意过程中的重大缺陷,这损害了患者的自主权。实施提高知情同意质量的解决方案对于保护患者自主权和保护外科医生免受诉讼是必要的。证据等级:四级。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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