It's Called "Informed Consent," But How "Informed" Are Patients? A Patient Perspective on Informed Consent in a Tertiary Care Hospital in Saudi Arabia

Abstract

Objectives: To examine the patient's perspective of the informed consent process, particularly with regards to reading the informed consent form, understanding and recall of the informed consent.

Methods: Between June and August 2022, 281 patients/proxies at King Fahad Medical City, Saudi Arabia, were surveyed within 7 days before having a medical procedure.

Results: In all, 66.2% of patients did not read the consent before signing. Around 76.2% of patients said they fully understood the information given, 14.9% only partially understood, and 8.9% stated that they had not understood. A total of 90.4% of patients were able to recall their diagnosis. About 27.4% were unable to state any benefit of the procedure. In all, 19.9% were unaware if there was an alternative to the procedure. Around 40.6% were unable to state any risks and only 58.4% could remember at least one risk.

Conclusions: A consent may be technically valid even when the patient has little understanding of the process; therefore, we must strive to ensure that we have ethically valid consent. From our findings, we conclude that informed consent has to be provided in an environment conducive to optimal patient understanding, for example, by ensuring that there is adequate time for explanation, preferably a day or 2 before the procedure. Informed consent should not be taken immediately before a (nonurgent) procedure. Secondly, due to the great variance in understanding between patients, it is vital for the physician to assess the patient's understanding of the consent process, this may be achieved using feedback methodology.