Knowledge and Perception of Ethiopian Surgical Patients to Informed Consent Practice for Surgical Procedures

Background: Surgical informed consent (SIC) is an established ethical and legal requirement for surgical treatment. Patient understanding of the process is essential for efficient surgical care. This study aimed to assess the knowledge and perception of operated patients towards surgical informed consent. Methods: An institution-based cross-sectional study of all adult surgical patients who signed informed consent and underwent surgery at St. Paul's Hospital Millennium Medical College (SPHHMC) from February 1st to March 30th, 2018, was performed. Data were collected postoperatively before discharge using a pretested structured questionnaire. Results: Of 420 patients identified, 385 (91.7%, M:F=2:1) agreed and interviewed. The mean age was 40.3 years (SD +/- 15.1), and many of the respondents (285, 74.0%) had some level of formal education. Even if most (336, 87.3%) knew the reason why they had surgery, less knowledge and awareness was reported regarding the options of alternative treatments (153, 39.7%), identifying the operating surgeon (129, 33.5%), the type of surgery (160, 41.6%), anesthesia-related risks (96, 24.9%), complications of surgery (69, 17.9%) and postoperative care (4, 1.0%). The legal requirement of surgical informed consent was reported by 267 (69.4%) subjects; however, more than half had no information on the right to change their mind after signed surgical informed consent (223, 57.9%) and whom it protects (224, 58.2%). Only 40 (10.5%) respondents had a good level of knowledge, and it was significant in those with some level of formal education (OR=4.8; 95% CI 1.45-16.01; P=0.010) and in patients who live in an urban area (OR=4.7; 95% CI 1.81-12.35; p=0.002) than their respective groups. Conclusion: Our patients had limited knowledge and perception regarding surgical informed consent. Hence, the current consent process seems inadequate and needs a revisit.