Attitude of Surgeons Working in General Governmental Hospitals Towards Informed Consent, Kuwait

Background: Informed consent in medical practice means an acceptance of a medical or surgical intervention by the patient during hospital care. It helps patients to discuss with treating doctors about their conditions. Informed consent is considered crucial. It is a mutual understanding and agreement between care providers and patients. During informed consent process the patient is required to be informed about everything of the proposed intervention and this depends on the knowledge of the care provider in collecting and providing information to patient. Objective(s): To assess the attitude of surgeons working in General Governmental hospitals towards informed consent in Kuwait. Methods: A cross-sectional study was conducted from January to June 2016 in secondary health care hospitals. A self-administered questionnaire about informed consent for surgery was completed by 353 randomly selected surgeons working at various surgical specialties in five governmental general hospitals in Kuwait. The questionnaire was developed to examine the surgeons' attitudes towards informed consent. They were asked to respond to each question by Yes (agreeing) or No (disagreeing) or Unsure. The responses of the surgeons to each statement were calculated using Statistical package SPSS version 21. Results: Public surgeons considered informed consent routinely achieved in their current practice (87.8%). They thought that all doctors should receive formal training on informed consent (79.3 %), while only 35.7% of them actually received training on informed consent. On the other hand, most public surgeons thought that written information leaflets should be provided for patients during informed consent (82.2%). However, only 41.1% of them provided their patients with leaflets during informed consent. Furthermore, 83% of public surgeons thought that the main purpose of informed consent is to provide the surgeon with greater protection against litigation. Similarly, 89.5% public surgeons thought that the main purpose of informed consent is to respect the patient’s right of autonomy. The majority of surgeons thought that the main purpose of informed consent is to improve the doctor patient relationship (83.0 %), and 81.0% of public surgeons thought that the main purpose of informed consent is to improve the patient’s compliance with medical care. Lower percentages thought that informed consent may be unnecessary because most patients depend on their doctor to make the decision for them (24.4%). Finally, 85.6% of public surgeons thought that the doctor who is going to perform the operation, should do the informed consent. More than half of the surgeons thought that the patients age, level of education, the patient’s clinical presentation whether emergency or elective, the complexity and duration of surgery, social class and the need for referral to another doctor or hospital, affects the amount of information given during informed consent. Conclusion: Surgeons in general public hospitals should be more aware of the informed consent guidelines and they should adhere to them. In addition, introduction of formal training on informed consent in all hospitals is recommended and making written information more widely available is important.