Informed consent in cardiac surgery - current institutional practice and legislation

Background/Aim. Growing waiting lists for cardiac surgery have become a real problem in the Republic of Serbia, imposing serious difficulties in patient-surgeon communication. The aim of the study was to determine the current state of the institutional informed consent policy before elective cardiac...

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Main Authors: Karadžić-Kočica Milica, Ugrinović Hristina, Grujić Miloš, Lazović Dejan, Vučićević Filip, Panić Goran, Kočica Mladen
Format: Article
Language:English
Published: Military Health Department, Ministry of Defance, Serbia 2022-01-01
Series:Vojnosanitetski Pregled
Subjects:
Online Access:http://www.doiserbia.nb.rs/img/doi/0042-8450/2022/0042-84502100029K.pdf
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author Karadžić-Kočica Milica
Ugrinović Hristina
Grujić Miloš
Lazović Dejan
Vučićević Filip
Panić Goran
Kočica Mladen
author_facet Karadžić-Kočica Milica
Ugrinović Hristina
Grujić Miloš
Lazović Dejan
Vučićević Filip
Panić Goran
Kočica Mladen
author_sort Karadžić-Kočica Milica
collection DOAJ
description Background/Aim. Growing waiting lists for cardiac surgery have become a real problem in the Republic of Serbia, imposing serious difficulties in patient-surgeon communication. The aim of the study was to determine the current state of the institutional informed consent policy before elective cardiac surgical procedures in light of actual nation-al legislation. Methods. An anonymous, voluntary survey was conducted among 200 consecutive patients at the Clinic for Cardiac Surgery, University Clinical Centre of Serbia, from September to December 2019, after signing an official institutional consent form. A targeted questionnaire was created to determine the quantity and quality of patients’ in-formation 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% had some information and graded them as non-sufficient. Surprisingly, 81.5% of patients 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 in-formation 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%) comprehends the importance and expects 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 the actual informed consent policy in cardiac surgery.
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spelling doaj.art-d4589663458a43fc85599eb0af279c8c2022-12-22T00:54:15ZengMilitary Health Department, Ministry of Defance, SerbiaVojnosanitetski Pregled0042-84502406-07202022-01-0179769770710.2298/VSP200115029K0042-84502100029KInformed consent in cardiac surgery - current institutional practice and legislationKaradžić-Kočica Milica0Ugrinović Hristina1Grujić Miloš2Lazović Dejan3Vučićević Filip4Panić Goran5Kočica Mladen6https://orcid.org/0000-0002-1391-5053University Clinical Center of Serbia, Center for Anaesthesiology, Reanimatology and Intensive Therapy, Belgrade, Serbia + University Clinical Center of Serbia, Clinic for Cardiac Surgery, Belgrade, SerbiaUniversity Clinical Center of Serbia, Center for Anaesthesiology, Reanimatology and Intensive Therapy, Belgrade, Serbia + University Clinical Center of Serbia, Clinic for Cardiac Surgery, Belgrade, SerbiaUniversity Clinical Center of Serbia, Clinic for Cardiac Surgery, Belgrade, Serbia + University of Belgrade, Faculty of Medicine, Belgrade, SerbiaUniversity Clinical Center of Serbia, Clinic for Cardiac Surgery, Belgrade, SerbiaUniversity Clinical Center of Serbia, Clinic for Cardiac Surgery, Belgrade, SerbiaUniversity Clinical Center of Serbia, Clinic for Cardiac Surgery, Belgrade, SerbiaUniversity Clinical Center of Serbia, Clinic for Cardiac Surgery, Belgrade, SerbiaBackground/Aim. Growing waiting lists for cardiac surgery have become a real problem in the Republic of Serbia, imposing serious difficulties in patient-surgeon communication. The aim of the study was to determine the current state of the institutional informed consent policy before elective cardiac surgical procedures in light of actual nation-al legislation. Methods. An anonymous, voluntary survey was conducted among 200 consecutive patients at the Clinic for Cardiac Surgery, University Clinical Centre of Serbia, from September to December 2019, after signing an official institutional consent form. A targeted questionnaire was created to determine the quantity and quality of patients’ in-formation 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% had some information and graded them as non-sufficient. Surprisingly, 81.5% of patients 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 in-formation 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%) comprehends the importance and expects 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 the actual informed consent policy in cardiac surgery.http://www.doiserbia.nb.rs/img/doi/0042-8450/2022/0042-84502100029K.pdfethic, medicalinformed consentlegislationphysician-patient relationrisk assessmenttherapeuticsthoracic surgeryserbia
spellingShingle Karadžić-Kočica Milica
Ugrinović Hristina
Grujić Miloš
Lazović Dejan
Vučićević Filip
Panić Goran
Kočica Mladen
Informed consent in cardiac surgery - current institutional practice and legislation
Vojnosanitetski Pregled
ethic, medical
informed consent
legislation
physician-patient relation
risk assessment
therapeutics
thoracic surgery
serbia
title Informed consent in cardiac surgery - current institutional practice and legislation
title_full Informed consent in cardiac surgery - current institutional practice and legislation
title_fullStr Informed consent in cardiac surgery - current institutional practice and legislation
title_full_unstemmed Informed consent in cardiac surgery - current institutional practice and legislation
title_short Informed consent in cardiac surgery - current institutional practice and legislation
title_sort informed consent in cardiac surgery current institutional practice and legislation
topic ethic, medical
informed consent
legislation
physician-patient relation
risk assessment
therapeutics
thoracic surgery
serbia
url http://www.doiserbia.nb.rs/img/doi/0042-8450/2022/0042-84502100029K.pdf
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AT lazovicdejan informedconsentincardiacsurgerycurrentinstitutionalpracticeandlegislation
AT vucicevicfilip informedconsentincardiacsurgerycurrentinstitutionalpracticeandlegislation
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