August 9, 2012
Full Treatment Disclosure A Priority For Patient Empowerment
Connie K. Ho for redOrbit.com — Your Universe Online
Information is key. That´s the message of a new study that examined past disclosures by physicians. In particular, the researchers discovered that, due to various reasons, doctors don´t disclose all the possible risks associated with certain treatments to their patients.
The study, written by international experts from Australia and the U.S., described how doctors are increasingly needed to advise and empower patients to make choices. As such, they will share information, including possible risks, which may affect patients´ decision on treatment. The authors believe that physicians, especially surgeons, aren´t sure which risks to discuss with patients before commencing treatment. The findings are published in a recent edition of PLoS Medicine.
"Documenting consent discussions in the lead-up to surgical procedures is particularly important, as most informed consent claims and complaints involved factual disagreements over the disclosure of operative risks," explained the authors in a prepared statement.
Doctors may sometimes underestimate the importance of letting patients know the risks associated with a particular treatment.
“Increasingly, doctors are expected to advise and empower patients to make rational choices by sharing information that may affect treatment decisions, including risks of adverse outcomes,” mentioned lead author Dr. Marie Bismark, a researcher from the University of Melbourne School of Population Health, in a prepared statement. “However, doctors, especially surgeons, are often unsure which clinical risks they should disclose and discuss with patients before treatment and this is reflected in this study.”
In the project, the researchers looked at 481 malpractice claims and patient complaints from Australia. Many of the disputes involved allegations on the deficiencies that resulted from trying to obtain informed consent. Out of the 481 cases, 45 were disputed duty-cases and included disagreements regarding information that should have been disclosed before treatment. Two-thirds of the cases were related to surgical procedures. As well, a majority of the cases were associated with outcomes on quality of life and related to issues like chronic pain, sexual dysfunction, vision or hearing loss, and the need for another operation. Nine of the ten cases were related to factual disagreements.
"Documenting consent discussions in the lead-up to surgical procedures is particularly important, as most informed consent claims and complaints involved factual disagreements over the disclosure of operative risks," commented the authors in the statement.
Based on their findings, physicians were most likely not going to disclose particular risk before treatment if that specific risk was rare or if that particular risk was under another more general risk.
“Our findings suggest that doctors may systematically underestimate the premium patients place on understanding certain risks in advance of treatment," remarked the authors.
According to the investigators, open communication is key to avoiding factual disagreements.
“The best way to avoid this type of ℠he said/she said´ dispute is by keeping a clear record of the consent discussion that takes place before any surgical procedure," related Bismark in the statement.
The authors also believe that more research is need in understanding this particular topic.
"Improved understanding of these situations helps to spotlight gaps between what patients want to hear and what doctors perceive patients want–or should want–to hear. It may also be useful information for doctors eager to avoid medico-legal disputes," noted the authors in the statement.