INFORMED CONSENT AMONG CHRONICALLY ILL ELDERLY - ASSESSING ITS (IN)ADEQUACY AND PREDICTORS

Physicians are legally and ethically required to obtain informed conse nt from patients prior to providing medical care. However, the chronic ally ill elderly may poorly understand the facts that are needed for t hem to make informed choices, and they also may wish to avoid discussi ng potentially discouraging information. interviews of 142 elderly hem odialysis patients were conducted to determine whether informed consen t for performing dialysis had been obtained and to explore potential c auses of inadequate informed consent. As predicted, most patients lack ed information needed to render fully informed consent. However, when we examined potential causes for the very low levels of knowledge repo rted by patients, Ive found that patients' education level, cognitive capacity and willingness to discuss medical contingencies were stronge r predictors of informed consent than were the communicative practices of doctors. Neither doctors' willingness to promptly disclose the nee d for dialysis nor their willingness to discuss forgoing dialysis were related to anp of the patient characteristics. Results suggest that o btaining fully informed consent for chronically ill elderly requires b oth a modification of doctors' communication practices and greater ada ptation to the cognitive capacity, education, and communication practi ces of the patient.