The informed consent process for anaesthesia: perspectives of elective surgical patients at Inkosi Albert Luthuli Central Hospital, Durban, South Africa

Abstract

Background: Amongst state hospitals in the eThekwini municipality, obtaining informed consent for anaesthesia is often an informal interaction between the patient and anaesthetist, lacking structure and standardisation.

Objectives: To evaluate the informed consent process from the patients’ perspective in an attempt to modify current practice.

Methods: Competent adult patients presenting for elective surgery were presented pre- and postoperatively with structured questionnaires addressing various aspects of the consent process.

Results: Of 143 included patients, only 57% of patients were given information about their anaesthetic preoperatively. With regard to complications experienced during anaesthesia, 36% of patients preferred not to be informed of any possible sequelae, while 17% wanted to be informed of all possible complications. In total, 83% of patients who had signed the surgical consent form with the surgeon thought that they had signed an anaesthetic form with the anaesthetist. Some 56% of patients felt that written consent on a specific standardised anaesthetic consent form should be introduced.

Conclusion: Even though the majority of patients are being seen preoperatively by the anaesthetist, the quality of this assessment is concerning, in terms of the amount and depth of information imparted and the lack of standardisation of information given.

Keywords: anaesthetic risk, bioethics, complications and anaesthesia, informed consent, patient and anaesthesia