Review Question - QID 86

The patient should give verbal informed consent by understanding the important risks and benefits (not necessarily every potential complication that could possibly occur), as well as the indications for and alternatives to a procedure. This should be performed prior to administration of narcotic medication. However, narcotic administration should not be delayed for patients in pain secondary to lack of availability of a written consent form, if the verbal conversation has occurred, as documentation of the consent process can still be performed prior to surgical intervention.

Wenger et al developed a survey of 102 orthopaedic surgeons who correctly answered a mean of nineteen (73%) of the 26 questions. The respondents appropriately handled questions involving economic aspects, truth-telling, confidentiality, and an incompetent colleague. However, there was less understanding of proper ethical conduct with regard to informed consent (58%), the physician-patient relationship (72%), and end-of-life decision-making (78%). There was also an analysis of the incorrect responses by the surgeons in the survey: Nineteen percent of the 102 respondents thought that a patient must be able to read the consent form, 39% thought that the patient must understand all of the risks of the procedure, 12% did not think that the patient needed to be able to communicate in some fashion to give their own consent, and 29% indicated that the patient must not be taking any medication with psychoactive effects.

The correct answers include; discussing the important (not necessarily all) risks and benefits as well as the indications for and alternatives to a procedure, ability to communicate with a patient that will give their own consent, and the use of antidepressant medications are not a preclusion to the informed consent process.