When informed consent goes poorly

January 01, 0001

When informed consent goes poorly

The aim of this study by researchers from Australia was to describe the frequency, characteristics, and outcomes of medicolegal disputes over informed consent. It consisted of retrospective review and analysis of negligence claims against doctors insured by Avant Mutual Group Limited and complaints lodged with the Office of the Health Services Commissioner of Victoria that alleged failures in the informed consent process and were adjudicated between 1 January 2002 and 31 December 2008.

A total of 481 cases alleged deficiencies in the informed consent process (11.5% conciliated complaints, 3.4% negligence claims, 57% of these cases were against surgeons). Plastic surgeons experienced dispute rates that were more than twice those of any other specialty or subspecialty group. 92% of cases involved surgical procedures and 16% involved cosmetic procedures. The primary allegation in 71% of cases was that the clinician failed to mention or properly explain risks of complications. Five treatment types — procedures on reproductive organs (12% of cases), procedures on facial features excluding eyes (12%), prescription medications (8%), eye surgery (7%) and breast surgery (7%) — accounted for 46% of all cases.

The researchers concluded: "The typical dispute over informed consent involves an operation, often cosmetic, and allegations that a particular complication was not properly disclosed. With Australian courts now looking to patient preferences in setting legal standards of care for risk disclosure, medicolegal disputes provide valuable insights for targeting both quality improvement efforts and risk management activities."

Patients don’t only need information but understand it to be informed … and full details. The main issue is explaining side-effects and risks of interventions.

For the full abstract, click here.

MJA 195 (6):340-344, 19 September 2011 © 2011 toThe Medical Journal of Australia
When informed consent goes poorly: a descriptive study of medical negligence claims and patient complaints. Andrew J Gogos, Richard B Clark, Marie M Bismark, Russell L Gruen and David M Studdert. Correspondence to David Studdert: d.studdert@unimelb.edu.au

Category: HSR. Health Services Research. Keywords: informed consent, medical negligence, claims, complaints, retrospective analysis, descriptive study, journal watch.
Synopsis edited by Dr Stephen Wilkinson, Melbourne, Australia. Posted on Global Family Doctor 7 October 2011

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.

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