Prior Informed Consent for Surgery in Children: Cross Sectional Study of Understanding and Recall of Risks by Parents and Guardians and Review of Relevant Medico Legal Literature

Abstract

Manoj Joshi, Ram Mohan Shukla, Dileep Garg, Maneesh Kumar Joleya*, Pooja Tiwari, Vinod Raj, Shashi Shankar Sharma, Ashok K Laddha and Brijesh K Lahoti

Introduction: In medical fraternity, all doctors, either physician or surgeon, do have ethical and legal duty, to take Informed Consent (IC) before any diagnostic or therapeutic procedure. Information to patient should be adequate enough to decide him voluntarily about taking or refusing treatment or procedure.

Materials and methods: This prospective longitudinal observational study was carried out at a tertiary care teaching hospital. Study period was 5 months from November 2020 to March 2021. Due to ongoing pandemic, the numbers of emergency as well as non- emergency cases were low. However, a total of 54 children (n=54) as surgical patients of minor age group were included in study.

Results: Out of total 54 patients, complete understanding score of 12 was achieved by 20.3% (n=11). Incomplete understanding was shown by 43 (79.6%) patient attendant. Overall, out of 54, 35 (64.8%) were emergency cases and 19 were non emergent cases. Of total 43 patients with incomplete understanding, 28 were emergency cases.

Conclusion: Our study highlighted that in prior informed consent procedure, risk recall or understanding of complications was far from satisfactory. Lower education status and emergency situations may have some adverse impact on understanding of parents. This may create grounds for parental dissatisfaction which are basis of possible medico legal situations if some adverse results or outcome arise.