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Volume 10 Supplement 1

de Senectute: Age and Health Forum

Informed consent: results of a study in a geriatric surgery division

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Background

Informed consent is a process during which the physician informs the patient of his diagnostic and treatment options; informing the patient about the risks of the procedure as well the benefits, can help him/her to make a rational decision regarding his health. A paternalistic relation between the physician and the patient is antithetical to the concept of informed consent [1]. In elderly patients’ impaired decisional capacity, observed in relation to the presence of neurological pathologies like Alzheimer disease and associated disorder [2], can influence the collection of a valid informed decision.

The capacity in elderly patients of a surgery geriatric division was evaluated to discuss the possible implications from an ethical and legal point of view of a correct collection of an informed consent

Patients and methods

The study is conducted on 100 patients aged over 70 years, hospitalized in a geriatric surgery division during the period September - November 2009. The methodological approach is based on the following steps: 1. analysis of medical documentation; 2. anamnesis; 3. collection of data concerning education, previous informed consent, knowledge of diagnostic and treatment options; 4. clinical-behavioral examination by means of administration of Mini-mental state examination (MMSE) and clock drawing test. The collected data are recorded in a database.

Results

Preliminary results in some cases highlight impaired cognitive functions that could influence the expression of a valid informed consent.

Conclusions

Informed consent is relevant from an ethical and legal point of view. The analysis of the data highlights the importance of the physician – patient relationship in the collection of the informed consent. In some cases the physician should be aware of the possibility of identifying the patient’s characteristics associated with impaired capacity; in such cases formal capacity evaluations and/or enhanced consent procedures may be most appropriate.

References

  1. 1.

    Humayun A, Fatima N, Naqqash S, Hussain S, Rasheed A, Imtiaz H, Imam SZ: Patients' perception and actual practice of informed consent, privacy and confidentiality in general medical outpatient departments of two tertiary care hospitals of Lahore. BMC Medical Ethics. 2008, 9: 14-10.1186/1472-6939-9-14.

  2. 2.

    Karlawish JH, Casarett DJ, James BD: Alzheimer's disease patients' and caregivers' capacity, competency, and reasons to enroll in an early-phase Alzheimer's disease clinical trial. J Am Geriatr Soc. 2002, 50: 2019-2024. 10.1046/j.1532-5415.2002.50615.x.

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Author information

Correspondence to C Terranova.

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Open Access This article is published under license to BioMed Central Ltd. This is an Open Access article is distributed under the terms of the Creative Commons Attribution 2.0 International License (https://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Terranova, C., Bruttocao, A. & Nistri, R. Informed consent: results of a study in a geriatric surgery division. BMC Geriatr 10, A36 (2010) doi:10.1186/1471-2318-10-S1-A36

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Keywords

  • Alzheimer Disease
  • Capacity Evaluation
  • Consent Procedure
  • Decisional Capacity
  • Drawing Test