The process of informed consent for urgent abdominal surgery

Objectives-To assess perceptions of the informed consent process in patient s undergoing urgent abdominal surgery. Design-A prospective observational study was carried out using structured q uestionnaire-based interviews. Patients who had undergone urgent abdominal surgery were interviewed in the postoperative period to ascertain their per ceptions of the informed consent process. Replies were compared to response s obtained from a control group undergoing elective surgery, to identify,fa ctors common to the surgical process and those specific to urgent surgery. Patients' perceptions of received information were also compared to the inf ormation perceived to have been provided by the consent obtainers. Setting-Gastrointestinal surgical service of a university teaching hospital . Patients-Seventy-four consecutive patients undergoing urgent abdominal surg ery and 80 control patients undergoing elective surgery. Main measurements-Principal outcome measures were patients' perceptions of factors interfering with the ability to give informed consent, assessment o f the quality of informed consent and the degree of discussion of the expec ted outcomes. Results-Forty-nine of the seventy-four (66%) patients undergoing urgent sur gery perceived that pain did not affect their ability to give informed cons ent. Twenty-seven reported an adverse effect of analgesia oil the ability t o give informed consent. Only 22% of patients undergoing urgent surgery per ceived that there had been any, discussion of potential side effects and co mplications of surgery. Conclusion-The majority of patients in this series with acute intra-abdomin al surgical conditions perceive that they retain the ability to give inform ed consent for surgery. There is a need for improved discussion of therapeu tic options and likely outcomes.