A survey of Haitian attitudes towards informed consent

Background Universal standards for bioethics, including the tenet of informed consent, should be upheld in the setting of humanitarian medical missions. The obstacles to obtaining informed consent in the global health setting have been thoroughly discussed in the literature, but no studies have investigated these issues from the patient’s perspective. We sought to understand the patient’s experience of the consent process during a four-week surgical mission to Haiti. Methods All patients selected for surgery during a mission to Hinche, Haiti, were invited to participate in a survey assessing communication between them and their physicians, their understanding of the surgical procedure, and their desire for information during the consent process. Complete data were collected from 55 patients. Results Understanding a basic explanation of surgery and the associated risks was important to 98% of Haitian surgical patients, and 96% reported the desire for extensive risk communication. All patients felt that they should demonstrate their understanding of the surgery by signing a consent form before undergoing surgery. No demographic factors correlated with patient desire for additional information regarding surgical risk. Conclusions Our results highlight several areas needing improvement in the consent process during surgical missions, including deliberate and consistent use of a consent process as well as more extensive risk communication. Our survey demonstrates that the process of obtaining informed consent for surgery is important to Haitian patients in the setting of short-term surgical missions and suggests that continued efforts to improve our methods are necessary.