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Informed Consent in Surgery
Informed Consent in Surgery
Informed Consent in Surgery
IN SURGERY
By: Dr. GLORY ENOCHE ALAPA
House Officer
Department of Surgery UATH
Supervisor:
Dr. OKPAKO Isaac Oghenero.
Senior Registrar Plastic Surgery Division
Department of Surgery
University of Abuja Teaching Hospital Gwagwalda
Date 22/04/2024
Outline
Introduction
Historical perspective
Types of Consent
Components informed consent in surgery
Benefits of an informed consent
Who takes informed consent?
Who can give informed consent?
Stages of informed consent
The informed consent form
Informed consent in special cases
Factors that make a faulty consent
The UATH Experience
Conclusion
References
INTRODUCTION
However it was not until 1957 when it was publicly recorded in the court
document for the case of Salgo vs Leland Standford Jr University Board of
Trustees that the name and principles of informed consent came to be and
became legally binding
Historical perspective – Nigeria
The professional conduct of medical doctors is guided by the Code of
Medical Ethics in Nigeria, in which Rule 19 of part A deals with
informed consent.
Most laws in Nigeria emanates from the British legal system like wise
informed consent and this is not surprising as Nigeria was a colony of
the British empire
There are not enough legal cases to set the rules for informed
consent in Nigeria a clear departure from the above was a landmark
judgment in 2001 between Medical and Dental Disciplinary Tribunal
vs. Okonkwo,
Historical perspective – Nigeria
In Medical and Dental Disciplinary Tribunal vs. Okonkwo, the appellant, Dr Okonkwo, was found
guilty of professional misconduct.
He had honoured the verbal and written wishes of a Jehovah’s Witness patient who refused blood
transfusion and consequently died during treatment.
The Nigerian appellate court upheld Dr Okonkwo’s appeal and the Supreme Court concurred.
The apex court ruled that an adult Nigerian has a right to refuse life prolonging medical treatment,
including blood transfusion. The court located that right in the constitutional right to privacy and
freedom of thought, conscience and religion.
Treatment/Intervention
Risk/complication
Alternative treatment
Prognosis
Benefit of an informed consent
2. Provision of information
-Patient education
-Recommendation of a care plan
-Understanding of this information by the patient
3. Stage of consent
-Patient consenting to the surgical procedure
-Recording of this authorization
The informed consent Form
• The consent form must have
• A title
• Information of the consenter (Age, Sex,
Occupation, signature)
• Diagnosis of the condition
• Treatment being offered
• Express agreement that patient
understands the diagnosis, options of
care, procedure/treatment,
complications prognosis
• Information of the doctor giving the
consent
• Information of the doctor performing the
surgery
• Information of the members of the team
Informed consent in special cases
The consent form may not be substituted for a version that has been
translated
Consent in special cases - Informed consent from an
illiterate
Mental retardation
Mental illness
Alcohol intoxication
Altered mental state
Severe brain injury
Minor
The UATH experience
- Informed consent Protects the patient’s human right and upholds a Surgeon
integrity in practicing Medicine .
Ezeome ER, Marshall PA. Informed consent practices in Nigeria. Dev World Bioeth. 2009 Dec;9(3):138-48.
doi: 10.1111/j.1471-8847.2008.00234.x. Epub 2008 Apr 29. PMID: 18452553.
Bazzano LA, Durant J, Brantley PR. A Modern History of Informed Consent and the Role of Key Information.
Ochsner J. 2021 Spring;21(1):81-85. doi: 10.31486/toj.19.0105. PMID: 33828429; PMCID: PMC7993430.
- Anderson, O. and Wearne, I. (2007) Informed consent for elective surgery
-Medical and Dental Council of Nigeria: Codes of Medical ethics in Nigeria.
- examination of the consent form of the Ahmadu Bello University Teaching Hospital Zaria MR3
- Federal Republic of Nigeria. Constitution of the Federal Republic of Nigeria. Apapa: Federal printing
Press; 1999.
- The Doctrine of informed consent- African online journals –YZ Lawal 2007
Informed consent | PPT (slideshare.net)
THANK YOU