Informed consent: a survey of physician outcomes and practices

We mailed a survey to the domestic membership of the American Society of Gastrointestinal Endoscopy in an attempt to investigate how endoscopists obtained informed consent and the effect of these practices on medical malpractice claims. One thousand two hundred thirty-two (23.8%) surveys were returned. We determined that although informed consent is obtained in 98.5% of endoscopic cases, 30% of physicians leave the task of obtaining such consent to hospital or office personnel. Although endoscopists tend to be complete in terms of describing the risks of procedures to patients, all risks are not revealed equally; some complications, for example, the risk for requiring a colostomy, are disclosed by relatively few physicians, perhaps revealing a higher comfort level with a particular procedure, such as colonoscopy. Like-wise, endoscopists generally explain the benefits of and alternatives to procedures, but they do not explain the more hazardous alternatives. Documentation of the informed consent process is an area in which physicians could be more thorough. Twenty-one percent of respondents had been sued, and in 42% of these instances, the informed consent process was an issue. Lawsuits in general (38%) changed the way respondents obtained consent, especially (64%) when this process had been an issue in the suit. No correlation was found between either the thoroughness of the informed consent process or the status of the person who obtained consent and the likelihood of being sued.